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Prior Authorization
Mercy Care Long Term Care requires prior authorization for selected acute outpatient services and planned hospital admissions. Prior authorization is not required for emergency services.
To request prior authorization electronically, visit MercyOneSource.
Timeframes for Processing Requests
Long Term Care Covered Benefits
Check the Status of a Prior Authorization
Forms
Prior Authorization Request Form
Durable Medical Equipment, Orthotics and Prosthetics Prior Authorization Request Form
Therapy and Home Health Prior Authorization Form
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Supporting Information
- Regulatory
- Medical Policies
- Facilities
4350 E. Cotton Center Blvd.,
Bldg D, Phoenix,
Arizona 85040
Member Services
7 a.m. to 6 p.m. Monday-Friday
602-263-3000,
Toll-free 1-800-624-3879
(TTY/TDD)
Toll-free: 1-866-602-1982
If you or a family member has a medical emergency, dial 911.