Thank you for your continued partnership in supporting L.A. Care’s No Authorization Required process. Since its launch on July 25, 2024, we’ve made significant progress in reducing unnecessary prior authorization requests. However, we’re still receiving approximately 7,500 monthly requests for services and items that do not require prior authorization.
This results in nearly 1,000 hours of manual processing time—time that could be better spent on patient care.
What You Need to Do
To optimize efficiency and reduce administrative work, we need your help:
Before submitting any prior authorization requests, please always check the Provider Prior Authorization Tool at this link. If the tool shows no authorization is needed for in-network services, do not submit a request to L.A. Care’s Utilization Management Department. Submitting unnecessary prior authorization requests only delays the process and wastes valuable time for everyone involved.
Key UM Reminders for Smooth Processing:
- Specify units: If a prior authorization is required, be sure to include the exact number of units for the 3-month period.
- DME/Medical Supplies: A prior authorization is required if durable medical equipment or supplies exceed quantity or frequency limits.
- Complete forms thoroughly: Ensure that all required fields on the prior authorization form are filled out before submission.
Need Help?
- For questions about the No Prior Authorization Required process, please contact your Account Manager.
- For inquiries about submitted authorizations, email our Utilization Management team at: UM_Operations_Mailbox@lacare.org.
Your collaboration is critical to ensuring a faster, more efficient process for everyone. Thank you for your attention to this important matter!