Part-C Pre-Authorizations

As a Golden Coast MSO member you can request a self-referral (pre-authorization) to see a specialist or receive medical services and items. Typically, your provider will do this for you.

When you or your provider send a pre-authorization, Golden Coast MSO reviews and makes an organization determination. An organization determination is the first decision Golden Coast MSO makes about covering a medical service or item you have requested.

If the pre-authorization is a standard request, we will notify you of a decision within 14 calendar days (72 hours for Standard Part B Drug requests).

There are times where you or your provider may submit an expedited pre-authorization for a fast organization decision. An expedited pre-authorization qualifies for a fast decision if we determine that your life, health, or ability to regain maximum function may be seriously jeopardized by waiting for a standard request.

If the pre-authorization is an expedited request, we will notify you of a decision within 72 hours (24 hours for Expedited Part B Drug requests).

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Download Forms

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Click below to download a PDF version of the Pre-Authorization Form for your health plan.