Service Authorization Requests (SAR) Overview
Partners’ Utilization Management (UM) team reviews initial, continuing care and retrospective requests to determine medical necessity. UM decisions are guided by North Carolina Division of Health Benefits (DHB) Clinical Coverage Policies and Division of Mental Health, Developmental Disabilities and Substance Abuse Services (DMHDDSUS) State-Funded Service Definitions.
A Service Authorization Request (SAR) is required for services needing prior approval. All SARs should be submitted through ProAuth, Partners’ secure authorization system.
For SAR issues, please review the ProAuth System Assistance section below.
If you are experiencing issues accessing ProAuth or submitting authorizations, please follow the steps below.
Login or Password Issues
If you are having problems accessing ProviderCONNECT or ProAuth related to logins or passwords, please email:
ProviderCONNECTSupport@partnersbhm.org
ProAuth Site Not Loading or Displaying a White Screen
If ProAuth is operational but not loading properly, please try clearing your internet browser cache. You may also need to adjust your browser settings to allow pop-ups.
To clear cache in Google Chrome:
Click the three-dot menu → Select “More Tools” → Select “Clear browsing data.”
Issues Completing an Authorization in ProAuth
If you are experiencing issues completing an authorization in ProAuth, please email the Partners ProAuth Team at:
Include:
- A screenshot of the issue (showing the top, bottom and left side of the screen)
- The provider site location selected (not the NPI)
- Confirmation that the Provider Filter at the top of the screen is turned on (the circle should be green before entering data)
Escalation to IT
If the ProAuth Team determines they are unable to resolve the issue, they will refer the matter to the Partners IT Support Team by submitting a service desk ticket. You will be copied on the ticket submission.
If necessary, the ProAuth Team will advise you to submit a Manual Authorization while IT addresses the issue.
If the issue is resolved before the Manual Authorization is entered, Partners staff may request that the authorization be submitted electronically in ProAuth.
Review the When to Use the Manual SAR Form section.
Partners IT Contact Information
Normal Business Hours: 704-842-6431
After Hours: 336-530-7124 (Partners Service Desk)
All SARs must be initiated in ProAuth.
Use ProAuth to:
- Start a new SAR
- Upload clinical documents
- Review the status of an existing SAR
- Respond to requests for additional information
ProAuth Site Not Loading or Displaying a White Screen
If ProAuth is operational but not loading properly, please try clearing your internet browser cache. You may also need to adjust your browser settings to allow pop-ups.
To clear cache in Google Chrome:
Click the three-dot menu → Select “More Tools” → Select “Clear browsing data.”
If you are experiencing issues completing an authorization in ProAuth, please email the Partners ProAuth Team at:
Include:
- A screenshot of the issue (showing the top, bottom and left side of the screen)
- The provider site location selected (not the NPI)
- Confirmation that the Provider Filter at the top of the screen is turned on (the circle should be green before entering data)
If the ProAuth Team determines they are unable to resolve the issue, they will refer the matter to the Partners IT Support Team by submitting a service desk ticket. You will be copied on the ticket submission.
If necessary, the ProAuth Team will advise you to submit a Manual Authorization Request Form while IT addresses the issue.
If the issue is resolved before the Manual Authorization Form is entered, Partners staff may request that the authorization be submitted electronically in ProAuth.
To prevent delays or denials, include all required information with your SAR:
Provider and Service Details
- Service provider name and site code
- Authorization date range
- Benefit plan:
- Tailored Plan Medicaid
- Tailored Plan Innovations
- Medicaid Direct B
- Medicaid Direct C
- Medicaid 1915(i)
- State-funded services
Member Information
- Guardian name and relationship (if applicable)
- Individual’s primary disability
- Mental health (MH)
- Intellectual/developmental disabilities (I/DD)
- Substance use disorder (SUD)
Required Clinical Elements
- American Society of Addiction Medicine (ASAM) level (recommended for SUD or co-occurring diagnosis)
- CANS scoring sheet (recommended for MH requests for children ages 3-5).
- Learn more at the PRAED Foundation; training and certification are available at canstraining.com.
- NC-SNAP or Supports Intensity Scale (SIS) for I/DD
- Primary care physician name and signed release of information
- Medication list, including name, dose, frequency and adherence
- ICD-10 diagnosis codes
- Substance use history (if applicable)
- Clinical justification for the requested services
- Required documents per benefit plan
- Authorization request documents for review (as applicable)
If UM needs additional information, you will receive a notice with a response deadline.
Failure to respond by the deadline may result in a denial.