To obtain an authorization on-line, please go to our online system, Valley Express; for more information please contact Provider Relations. If you do not have access to the on-line system, and you wish to obtain access, please fill out the Valley Express Access Request Form.
For Fax Authorizations, complete and submit the Authorization Request Form. Clearly identify the service requested and the medical justification for this service. The following information is required on the request:
- Diagnosis (ICD-10)
- Service Requested (CPT-4)
- Number of visits requested
- Reason the service is medically necessary, including documentation such as H&P and progress notes
- Name of rendering provider requested
- Name of referral provider submitting the request
Name of Member and Member’s VHP ID number
If the “Authorization Request Form” is not fully completed, the UM staff will request the needed information. If the additional information is not provided within 10 working days, the request will be closed. If the request has been closed, a new Authorization Request Form must be submitted to UM prior to performing services.
Post Stabilization Telephone Number
Valley Health Plan requires prior authorization for all post stabilization care. Effective immediately please be advised that the number to call 24hrs per day/7 days per week is 1-855-254-8264.
Any call to any phone number other than 1-855-254-8264 does not constitute notice of patient admission or request for post stabilization care.
A fax about a patient admission or request for transfer does not constitute notice of this request either. This request must come via phone call to 1-855-254-8264.