Prior Authorization for Medical Services and Organization Determination

Start by calling, writing, or faxing our plan to make your request for us to authorize or provide coverage for the medical care you want. You, your doctor, or your representative can do this.

Brand New Day
5455 Garden Grove Boulevard, Suite 500
Westminster, CA 92683

Fax: 562-981-5818

Member Services at: 1-866-255-4795 (TTY call 1-866-321-5955)
We are available for phone calls:

October 1 – February 14: 7 days a week, 8:00 a.m. – 8 p.m.
February 15 – September 30: Monday – Friday, 8:00 a.m. – 8:00 p.m.
Calls to these numbers are free

We will make a decision about your request generally within 14 days of receiving your request.

If you (or your doctor) have asked for a fast decision, we will answer within 72 hours of receiving your request.

You can ask for a fast coverage decision if you believe using the standard deadline (14 DAYS) could cause serious harm to your health or hurt your ability to function and you have not received the service yet.

If you ask for a fast coverage decision without the support of your doctor, we will decide if your health requires the quicker decision timeframe. If we decide your medical condition does not require a fast decision, we will make a decision using the standard deadline (14 DAYS).

If your doctor tells us that your health requires a fast decision, we will automatically make a decision within 72 hours.

We will call you and send you a letter with our decision on your request.