Geisinger Health Plan prior authorization criteria
Submission criteria, documentation packets, and P2P prep by drug — for prescribers and PA staff. 30-day standard PA decision.
Geisinger Health Plan reviews prior-authorization requests against its published medical policies — diagnosis with ICD-10 code, documented step-therapy history, and prescriber attestation of medical necessity. Standard PA decisions return in 30 days; if denied, prescribers and members have 180 days to appeal. Criteria by drug below.
Prior authorization criteria by drug
Each page covers Geisinger Health Plan's submission criteria, the documentation packet, and peer-to-peer prep for that drug.
- Adalimumab at Geisinger Health Plan →
- Aflibercept at Geisinger Health Plan →
- Apixaban at Geisinger Health Plan →
- Atezolizumab at Geisinger Health Plan →
- Atogepant at Geisinger Health Plan →
- Benralizumab at Geisinger Health Plan →
- Bevacizumab at Geisinger Health Plan →
- Bictegravir at Geisinger Health Plan →
- Buprenorphine at Geisinger Health Plan →
- Dapagliflozin at Geisinger Health Plan →
- Dulaglutide at Geisinger Health Plan →
- Dupilumab at Geisinger Health Plan →
- Eculizumab at Geisinger Health Plan →
- Elexacaftor Tezacaftor Ivacaftor at Geisinger Health Plan →
- Empagliflozin at Geisinger Health Plan →
- Erenumab at Geisinger Health Plan →
- Evolocumab at Geisinger Health Plan →
- Faricimab at Geisinger Health Plan →
- Fingolimod at Geisinger Health Plan →
- Fremanezumab at Geisinger Health Plan →
- Galcanezumab at Geisinger Health Plan →
- Glecaprevir Pibrentasvir at Geisinger Health Plan →
- Guselkumab at Geisinger Health Plan →
- Ibrutinib at Geisinger Health Plan →
- Imatinib at Geisinger Health Plan →
- Inclisiran at Geisinger Health Plan →
- Infliximab at Geisinger Health Plan →
- Ixekizumab at Geisinger Health Plan →
- Lenalidomide at Geisinger Health Plan →
- Liraglutide at Geisinger Health Plan →
- Lisdexamfetamine at Geisinger Health Plan →
- Mepolizumab at Geisinger Health Plan →
- Methylphenidate at Geisinger Health Plan →
- Naltrexone at Geisinger Health Plan →
- Natalizumab at Geisinger Health Plan →
- Nintedanib at Geisinger Health Plan →
- Nivolumab at Geisinger Health Plan →
- Nusinersen at Geisinger Health Plan →
- Ocrelizumab at Geisinger Health Plan →
- Ofatumumab at Geisinger Health Plan →
- Omalizumab at Geisinger Health Plan →
- Ozanimod at Geisinger Health Plan →
- Palbociclib at Geisinger Health Plan →
- Pembrolizumab at Geisinger Health Plan →
- Pirfenidone at Geisinger Health Plan →
- Ribociclib at Geisinger Health Plan →
- Rimegepant at Geisinger Health Plan →
- Risankizumab at Geisinger Health Plan →
- Rituximab at Geisinger Health Plan →
- Rivaroxaban at Geisinger Health Plan →
- Sacubitril Valsartan at Geisinger Health Plan →
- Secukinumab at Geisinger Health Plan →
- Semaglutide at Geisinger Health Plan →
- Sofosbuvir at Geisinger Health Plan →
- Tafamidis at Geisinger Health Plan →
- Tenofovir Alafenamide at Geisinger Health Plan →
- Tezepelumab at Geisinger Health Plan →
- Tirzepatide at Geisinger Health Plan →
- Tofacitinib at Geisinger Health Plan →
- Trastuzumab at Geisinger Health Plan →
- Upadacitinib at Geisinger Health Plan →
- Ustekinumab at Geisinger Health Plan →
Generate a Geisinger Health Plan PA packet
Open ApprovalHelp — generate a prior-auth packet tailored to Geisinger Health Plan's criteria, with prescriber attestation and step-therapy documentation pre-filled.
Get started →Contact: hello@approvalhelp.com