Gold Card Program

CMO Dr. Cara Christ and VP Clinical Operations Dr. Uche Olekanma talk about how this merit-based program streamlines the prior authorization process for qualifying providers.

  • We recognize AZ Blue network providers with proven clinical expertise by inviting them to participate in our Gold Card Prior Authorization Program. Participation is based on a strong track record of adhering to evidence-based clinical criteria and providing excellent healthcare to our members. To check your eligibility for the program, complete and email us the Gold Card Participation Eligibility Form.

  • Our Gold Card Prior Authorization Program offers pre-approved authorizations for services rendered to members with AZ Blue commercial group and individual benefit plans. It helps speed patient access to care and reduce administrative time.

    The program rewards top professional providers in the AZ Blue network who are known and trusted for their clinical excellence. We review our records and select only those providers with a prior authorization approval rate of at least 90% across a one-year period. Facility providers are not currently included in the program.

    For details, see the Program Policy & Procedures (PDF).

  • The process of obtaining a Gold Card prior authorization is simple:

    • Before the service is rendered, call the Gold Card hotline at 602-864-4811 for direct access to our Utilization Management team. After a few short questions have been answered, the authorization will be approved. That’s it. No further review will be necessary for Gold Card prior authorizations.
    • If the service requires prior authorization by eviCore, follow the normal request process (available 24/7) via the eviCore provider portal. After identifying the patient, provider, and service(s) to be rendered, your case will be approved without the usual clinical pathway process.

    To maintain the overall quality of the program, we will perform randomized audits on a regular basis.
    For an overview of the streamlined prior authorization process, see our one-page Program Summary (PDF).