Pre-authorization is required before treatment. If your procedure requires hospital stay, you must also pre-certify those days. Click here for pre-certification information.

All pre-authorization requests must be submitted in writing, either by mail or fax, with the exception of emergency treatment. Please allow a minimum of two (2) weeks for a response.

Submit pre-authorization requests to:

Fax: 801-972-364
PO Box 30749
Salt Lake City, UT 84130-0749

Written pre-authorization requests should include the following:

Diagnosis

Treatment Plan

Medical records for this diagnosis including any previous treatment for this diagnosis.

Photographs, if appropriate

If this will be performed as an in-patient, you will need to contact Intracorp to certify the number of days required for your procedure.