Highmark Outpatient Authorization Form

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Complete and fax all requested information below including any supporting. Web on this page, you will find some recommended forms that providers may use when communicating with highmark, its members or other providers in the network. Web authorization request form submission instructions: Behavioral health authorization request forms: 888.236.6321 or 800.670.4862 (delaware) inpatient:

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If you are requesting a drug that requires a prior authorization or step therapy, please complete the drug specific prior. 888.236.6321 or 800.670.4862 (delaware) inpatient: Web please fax completed form to clinical services: Our vision is to ensure that all members of the community have access to. As a south carolina bluecard ® provider, you.

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If you are requesting a drug that requires a prior authorization or step therapy, please complete the drug specific prior. Web highmark has your health insurance needs covered. Web manuals medical policy search esubscribe requiring authorization pharmacy policy search medical injectable drug forms medical specialty drug. Only one patient per fax.