About Authorizations

The Authorization function of NH MMIS collects and maintains current and historical information about service authorizations (prior authorizations) needed for reporting and claims processing. Providers can submit authorization to the Department of Health and Human Services (DHHS) via hardcopy, phone, web, and electronic transmission.

Providers and designated Provider Office Staff (POS) can request a service authorization (SA) to determine the necessity for providing a medical or dental service or procedure, home and community based care, or durable medical equipment.

Coverage under the Medicaid program is not guaranteed to the recipient or provider if the SA request is not submitted, validated, and approved prior to the service, procedure, or delivery of equipment. SA requests received via the New Hampshire MMIS Health Enterprise Portal are validated by the same processes as those mailed, entered electronically, or submitted by a batch process.

You are notified after a status is determined or if more information is required.

You can edit previously saved, and in certain instances, submitted service authorizations. In addition, you can copy service authorization records in order to enter and submit new SA requests. After an SA is submitted and validated by the system, the SA is added to the database and the record is assigned a unique SA ID number.