Certification Request Form

Welcome to the online certification portal website for precertification requests through the HealthChoice Certification Administrator, American Health Holdings (AHH). This online certification process is designed to improve the response time for completing your request for review.

To submit requests that require certification through the HealthChoice Health Care Management Unit (HCMU), please visit http://healthchoiceconnect.com/certification_portal_new.html and complete the appropriate form. Services reviewed by HCMU should not be submitted through this site; all other services requiring precertification should continue by selecting "Next" at the bottom of the screen.
HCMU reviews include:

  • Chiropractic
  • Drugs and Medical Injectable
  • DME (some exceptions apply)
  • Enteral Feeding
  • Foot Orthotics
  • Genetic Testing
  • Glucose Monitors: Continuous
  • Hearing Aids
  • Home Health Care (Visits limited to 100 per calender year)
  • Home Intravenous (IV) Therapy
  • Hyperbaric Oxygen Therapy (Outpatient)
  • Mental Health Treatment
    • Outpatient, Intensive Outpatient Therapy, TMS, Esketamine and ABA
  • Occupational Therapy
  • Oral Splints and Appliances
  • Oral Surgery
  • Oxygen
  • Physical Medicine/Physical Therapy (Outpatient)
  • Prostheses and Orthopedic Appliances
  • Proton Beam Radiation Therapy
  • Speech Therapy
  • Substance Use Disorder Treatment
    • Outpatient and Intensive Outpatient Therapy
  • Unlisted and Not Otherwise Specified

For a more detailed list of the service codes that require certification, please refer to the HealthChoice Certification Code List found on the HealthChoice Fee Schedule site or call HealthChoice Customer Care at 1-800-323-4314 and speak to a provider representative.

The information you may be asked to provide is required to ensure the accuracy of your request and to prevent unnecessary delays in the review process.

After completing this form, you will be contacted regarding the outcome of your request. If additional information is needed to complete the review, you will be contacted within one business day.

If you have an urgent/emergent case, please call 1-800-323-4314 and select Option 2.

Please have the following information available before you begin:

  • Member Identification number
  • Patient’s full name, address, and phone number
  • Diagnosis code(s)
  • CPT codes (if applicable)
  • Admitting/Ordering physician’s full name, address, phone number and tax ID
  • Facility name, address, phone number and tax ID

If you are experiencing technical issues with this site, please contact us at 866-270-2244. This is for technical issues only. For all other inquiries, please contact us via the emergency phone number listed above.