At Curative, we prioritize providing comprehensive and efficient healthcare coverage to our members. One of the key components of our commitment to your well-being is the requirement for prior authorization for certain medical services and treatments. Prior authorization is a decision to determine whether a health care service, treatment plan, prescription drug, or medical equipment is medically necessary. It is up to the member and the provider to request prior authorization. Please complete the forms below to be granted medical or prescription drug prior authorization.
We want you to get the best care possible. Prior authorization lets our medical experts check if a treatment is safe and based on what works best according to current medical knowledge and acceptable standards of care.
Your safety is important. With prior authorization, we can make sure a treatment won't harm you or have bad side effects.
Prior authorization helps us control healthcare costs. It means we only pay for treatments that are really needed, which keeps your insurance costs lower.
We have a network of doctors and hospitals we trust. Prior authorization makes sure you get care from these trusted places.
Prior authorization helps us plan your care so you get the right support and we don't miss anything.
It helps us spot and stop fake or unnecessary medical claims, which keeps your insurance strong and costs steady.
Curative Prior Authorization is granted by completing the medical and pharmacy prior authorization forms. For additional support, please contact Curative Provider Services at 855-414-1083. If you have previously submitted a claim or are contracted with Curative, feel free to complete this online form.
Prior authorization (PA) is a process that requires healthcare providers to obtain approval from our insurance company before prescribing certain medications. This process ensures that the recommended treatment is appropriate for the specific individual and that any potential risks or side effects are carefully evaluated.
When your healthcare provider recommends a service or treatment that requires prior authorization, they will submit a request to us.
Our team of medical experts will review the request based on (1) benefits coverage and (2) established guidelines and medical necessity.
If approved, you can proceed with the recommended treatment knowing that it meets evidence-based care protocols for quality and cost-effectiveness.
Your doctor can find the forms for prior authorization above or at curative.com/for-providers. Once received, the process may take up to one week to review. We encourage you to have your doctor submit this to us at the start of your plan year to prevent any delays in treatment.
Your Provider can also send the forms directly to Curative:
Phone: 855-414-1089, Fax: 888-293-4075, Email: firstname.lastname@example.org
Curative will notify your provider of a denial of services via mail and fax. The notification will include a description of the procedure for filing an Appeal. It will consist of a notice to the Participant of the right to appeal and the steps to obtain that review, including a copy of the form prescribed by the Texas Department of Insurance. An appeal may take up to 30 days to review. In cases where a request is denied, we will provide an explanation, and you and your provider can explore alternative options.
Common reasons for denial include:
Lack of Medical Necessity
Not a covered benefit
In the Experimental/Investigational phase