DialClerk Directory

CountyCare Health Plan

Prior authorization

Locate authorization teams and submission faxes. Medical, pharmacy and delegated reviews can follow different routes.

prior authorization

Medical Management and Prior Authorization Department

Official page read
Phone855-444-1661Published hours

Not published in this record

Product, plan and location

medicaid
Illinois

Mailing address

Not researched for this route

PA questions and phone requests; requests also through the secure portal (Identifi/Availity).

View source ↗ · Source checked 2026-10-24

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Wait time: not establishedBest time from caller reports: not established. Published hours are not a wait forecast.

fax prior auth

Inpatient medical prior authorization fax

Official page read
Phone

No phone listed for this route

Fax

800-856-9434

Published hours

Not published in this record

Product, plan and location

medicaid
Illinois

Mailing address

Not researched for this route

Fax the Inpatient Prior Authorization Form.

View source ↗ · Source checked 2026-10-24

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fax prior auth

Outpatient medical prior authorization fax

Official page read
Phone

No phone listed for this route

Fax

866-209-3703

Published hours

Not published in this record

Product, plan and location

medicaid
Illinois

Mailing address

Not researched for this route

Fax the Outpatient Prior Authorization Form (manual also lists this fax for medical pharmacy).

View source ↗ · Source checked 2026-10-24

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prior authorization

Evolent Specialty Services (formerly New Century Health) — medical oncology, cardiology, radiology oncology

Official page read
Phone888-999-7713Fax

702-726-5186

Published hours

Not published in this record

Product, plan and location

medicaid
Illinois

Mailing address

Not researched for this route

Menu guidance in the source record

Option 1

Menus can change. No live call verification is claimed.

Adult medical oncology, cardiology, radiology or radiation oncology authorization requests (option 1); online via the Evolent/New Century portal.

View source ↗ · Source checked 2026-10-24

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Wait time: not establishedBest time from caller reports: not established. Published hours are not a wait forecast.

prior authorization

Evolent Specialty Services (formerly NIA) — PT/OT/ST, MSK surgery, pain management, advanced imaging

Official page read
Phone800-424-1732Published hours

Not published in this record

Product, plan and location

medicaid
Illinois

Mailing address

Not researched for this route

Request via RadMD or by phone per the provider manual.

View source ↗ · Source checked 2026-10-24

Report an update
Wait time: not establishedBest time from caller reports: not established. Published hours are not a wait forecast.

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Call preparation · editorial guide

Make the call count.

Locate authorization teams and submission faxes. Medical, pharmacy and delegated reviews can follow different routes.

Have ready in your secure workspace

  • Ordering and rendering provider details
  • Service codes, requested dates and units
  • Existing authorization or submission reference

Questions to resolve

  • Is this the correct reviewer for this service and product?
  • Which documents are missing, and where should they be sent?
  • What is the case number and next status-check date?

This is a general administrative checklist, not payer policy or advice about a particular patient. Confirm the current plan instructions.

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