Accolade prior authorization for employer health plans

Accolade, a health advocacy company that has been part of Transcarent since April 8, 2025, takes precertification requests for some employer health plans. For those plans, the provider sends the request through Accolade’s precertification portal or calls Accolade Provider Services, and the employer’s plan sets which services need precertification. The combined company had more than 20 million members when the merger closed, according to Transcarent’s announcement (April 2025).

Accolade’s portal says precertification is a determination of medical necessity only and does not involve claim payment, eligibility, coverage or the availability of benefits. Accolade’s role also differs from one employer to the next, so a practice checks the member’s ID card first.

At a glance

• On a Meritain card for an Accolade plan, precertification goes to Accolade and claims to Meritain.
• Some employer pages list Accolade Provider Services at 866-417-0163.
• Some employers’ pages send imaging, fertility or high-cost drugs to other vendors.
• One employer’s 2022 Accolade list covered home health PT, OT and speech therapy.
• ERISA plans decide urgent claims within 72 hours and pre-service claims within 15 days, extendable once.

When Accolade takes the precertification request

The member ID card shows whether Accolade takes precertification for a plan. A Meritain Health sample card for a plan that partners with Accolade (2022) tells providers to call Accolade or visit precert.accolade.com for pre-certification, and to send claims to Meritain. For how Meritain plans work, see the Meritain Health prior authorization guide.

The University of California’s faculty and staff PPO says Accolade “is now owning prior authorizations and pre-certification” for the plan, with a dedicated utilization management department that reviews medical necessity, according to its Accolade FAQ (2026). The same FAQ tells members to call the number on the back of their insurance card to talk to Accolade about prior authorizations. Accolade’s member site says the services a member can use depend on the employer’s benefits.

Bring Silna your patients’ Accolade precertification requests

Submitting through Accolade’s precertification portal

Accolade’s precertification portal has a page for each employer plan. Its Start Request button opens accolade.getprecert.com, where a provider files a Precertification Request for a new request or a Clinical Update Request. For questions, the portal points to Accolade Provider Services.

Some employers’ pages send services to other vendors. On the pages checked in October 2026, one employer sends MRI, MRA and PET scan requests to Cigna / eviCore, another sends imaging requests through OneImaging, one sends infertility treatment requests to Progyny, and one asks providers to call CarelonRx to confirm prior authorization requirements for high-cost medications, infusions, injections and chemotherapy. Check the employer’s page before you send a request. For eviCore’s process, see the eviCore prior authorization guide.

Accolade prior authorization phone number

The Accolade prior authorization phone number for a patient is the Provider Services number on the member’s ID card. Some employer pages on Accolade’s portal also list Accolade Provider Services at 866-417-0163 for questions about a requirement the page names.

Accolade prior authorization form

The Accolade prior authorization form is the online Precertification Request at accolade.getprecert.com, reached through Start Request on the employer’s page. The same portal menu also has a Clinical Update Request.

Who sets the precertification list

Accolade’s portal says the precertification list is “solely the responsibility of customer and/or the applicable plan sponsor,” and that precertification should apply only to services the Summary Plan Description lists as requiring it. Two employers that both use Accolade can therefore require precertification for different services.

For example, a 2022 Accolade list for one employer plan required precertification for inpatient mental health and substance use disorder admissions, residential treatment facility stays, and home health physical, occupational and speech therapy. It told members that the provider is responsible for requesting it.

Federal deadlines for ERISA employer plans

For employer group health plans covered by ERISA, the federal claims rule, 29 CFR 2560.503-1, sets the plan’s decision deadlines:

Accolade’s portal lists no turnaround time of its own. Self-funded plans covered most workers enrolled in their employer’s health plan in 2025, according to KFF’s annual survey (October 2025):

Denials and appeals

An ERISA plan must give at least 180 days to appeal a denial. It decides a pre-service appeal within 30 days when the plan has one level of appeal, or within 15 days at each level when it has two, and an urgent care appeal within 72 hours. For an urgent claim, a health care professional with knowledge of the patient’s condition may act as the patient’s authorized representative.

The steps for other kinds of plans are in the guide to appealing a prior authorization denial.

Handing Accolade precertification to Silna

On each request, Silna checks the ID card and the employer’s page on Accolade’s portal, then sends medical and behavioral health requests to Accolade or the vendor the page names. At AnswersNow, it cut authorization turnaround by 76%, from 29 days to under 7 days on average, and as of October 2026 G2 reviewers rate it 4.8 out of 5 across 66 verified reviews. It also tracks each approval’s end date, and its insurance monitoring catches a change in the patient’s coverage.

Schedule a Silna call about your Accolade precertification work

Key terms

Plan sponsor

The employer or other organization that establishes the health plan and sets its terms.

Summary Plan Description

The plan document that lists, among other things, which services need precertification.

Precertification

Approval of a service as medically necessary before it is provided.

Utilization management

The review of whether a requested service is medically necessary.

Third-party administrator

A company that administers a plan’s claims for the plan sponsor.

Frequently Asked Questions

Does Accolade approve prior authorizations?

For employer plans that give it that role, yes. An Accolade approval covers medical necessity, so the practice still confirms eligibility, coverage and payment with the plan.

Which Accolade line takes provider precertification calls?

Accolade Provider Services, at the number on the member’s ID card. The employer’s page on precert.accolade.com may also name another vendor for some services.

Can a provider submit Accolade precertification online?

Yes. Start Request on the employer’s page at precert.accolade.com opens Accolade’s precertification portal, where the menu offers a Precertification Request and a Clinical Update Request.

Who decides what needs precertification?

The employer or plan sponsor, in the plan’s Summary Plan Description. Accolade’s portal says the list is the plan sponsor’s responsibility.

What federal deadline applies to an ERISA plan that uses Accolade?

For an ERISA plan, 72 hours for an urgent care claim and 15 days for a pre-service claim, extendable once by up to 15 days, under 29 CFR 2560.503-1.

This article is general educational information and does not give medical, legal or insurance advice. Each employer plan sets its own precertification rules, so check the member’s ID card and the employer’s page before you send a request.

About the author

Jeffrey Morelli

Jeffrey Morelli is the Co-Founder and CEO of Silna Health, the first Care Readiness Platform built to remove the administrative barriers that delay care. Silna automates benefit checks, eligibility, and prior authorizations across 1,000+ payors, and is backed by $27M from Accel and Bain Capital Ventures. Before Silna, Jeff spent a decade in San Francisco building and scaling products for highly regulated industries, including leading go-to-market at Truework (Series C, acquired by Checkr).

Last updated: October 23, 2026.