Update: Submit your Outpatient Prior Authorization Form and Attachments in eServices

As of May 29, 2025, Part B providers that perform procedures in an outpatient facility setting that require prior authorization can submit the Outpatient Department Prior Authorization (OPD) form in eServices. You can track the progress of the submission and see the decision for your submissions in the Messages.

Palmetto GBA’s free internet-based eServices Portal is the simplest and most efficient way to submit an Outpatient Department prior authorization request. It’s easy to register if you don’t already have an account. Just click on the link to see the introduction screen.

Once you’re in eServices, access the OPD Form via the Forms tab. If you don’t see Forms in the menu bar, reach out to your provider account administrator to request permission. 

From the Forms tab, choose "Prior Authorization" from the "Select a Topic" dropdown menu and "Outpatient Prior Authorization" from the "Select a Type" dropdown menu. The link to the form should appear in blue, just below the second dropdown menu. Once you click the link, you will be directed to the Outpatient Prior Authorization Form.

What you will need to submit the prior authorization request:

• Form permission in eServices (the Form tab will display in the menu bar)
• Name, address, Provider Transaction Access Number (PTAN) and National Provider Identifier (NPI) of the facility where the procedure will be performed
• Medical documentation supporting the need for the procedure

Complete the form and upload your attachments. It’s that easy!

Note: The facility provider will receive the decision letter.

Resources

• Outpatient Department Guide (PDF)
• eServices User Guide (PDF)
• Helping You Complete the OPA Request Form (YouTube video)