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Service approvals

Sometimes benefits, treatments and medicines need to be approved by MCC of AZ before you receive them. This is called prior authorization. You, your doctor, or someone you trust can ask for a prior authorization. An approval helps let us know if certain services or procedures are medically needed.

Some examples of services that need prior authorization are:

  • Outpatient surgeries
  • Medical supplies (i.e. wheelchairs)
  • A stay in the hospital
  • Pain management
  • Transplants
  • Orthotics
  • Prosthetics

You can see a list of services that require prior authorization here and see the complete list of prior authorization codes here.

If you have any questions about what needs a prior authorization, call Member Services at 800-424-5891 (TTY 711). Many services do not need to have an authorization.

We look at standards of care based on:

  • Medical policies
  • National clinical guidelines
  • Medicaid guidelines
  • Your health benefits

Magellan Complete Care of Arizona does not reward employees, consultants, or other providers to:

  • Deny care or services that you need
  • Support decisions that approve less than what you need
  • Say you don’t have coverage