Utilization Management
Bright HealthCare’s Utilization Management (UM) program exists to promote care that is evidence-based, affordable for your patients, a cost-effective use of healthcare resources, and in-network.
Submit Prior Authorizations Online
Submitting authorizations online is faster, easier, and offers many additional features not available when submitting via fax:
• Immediate confirmation of a successful authorization submission
• A reference number for each authorization
• Ability to view the status of an authorization
• Automatic approval for services that only need a network validation (Level 1 review)
How to submit prior authorizations online
Why you should submit prior authorizations online
Not all services require prior authorization
Instructions for Submitting Authorizations Online via Availity
- Log in to
- Click Patient Registration | Authorization & Referrals in the top left of the screen
- The Authorization & Referrals page displays
- Click Auth/Referral Inquiry or Authorizations to begin an electronic authorization request
For detailed step-by-step instructions on submitting authorizations electronically, please review the CareAffiliate User Guide.
IFP Prior Authorization Resources
Commercial Plans Prior Authorization List
Continuity of Care Request Form
Utilization Management Program Phone: 1-844-990-0375
Small Group Prior Authorization Resources
Small Group Plans Prior Authorization List
Continuity of Care Request Form
MA Prior Authorization Resources
HMO-POS Prior Authorization List
Utilization Management Program Phone: 1-844-929-0162
Need to Make a Change to an Authorization?
The authorization change request form can be used when Providers need to change any of the following items on an existing authorization.
Servicing Provider or Facility Name
Dates of Service for a planned procedure
The number of days/units/visits needed for a specific service
Use this form when you need to change information on a pending or approved authorization. Note that the form is not intended to add codes to an authorization. For an approval of additional services, please submit a new authorization request.
Case Management Bright HealthCare case management referrals can be submitted via phone or fax using the Case Management Referral Form. IFP Request via phone: 1-888-658-6818 MA Request via phone: 1-888-668-0804 Submit via fax: 1-833-903-1607
Bright HealthCare Data Regarding Approvals and Denials of Prior Authorization Requests
Per prior authorization bill HB19-1211 or C.R.S. § 10-16-112.5, the state of Colorado requires carriers and organizations to publish prior authorization data.
Questions? Contact Bright HealthCare Provider Services
Individual and Family Plans Call: 866-239-7191
Medicare Advantage Plans Call: 844-223-8380