Clinicians can submit requests by portal, by email, email Ascension Care Management Insurance Holdings at shp-authorization@ascension.org, by fax.

Prior Authorization Form. Fax to: (512) 380-7507. Referral ... TO BE COMPLETED BY ASCENSION CARE MANAGEMENT INSURANCE HOLDINGS MEDICAL MANAGEMENT SERVICES.

You may submit all inquiries for prior authorization requests via our interactive provider portal (24/7 - 365 days/year).

MAP & Charity Prior Authorization Form Download this form to request a prior authorization for MAP & Charity members. Charity Prior Authorization list ...

Prior authorization resources · How to obtain a prior authorization · Overview of services requiring authorization - see below for specific on the code list(s) ...

Inpatient Prior Authorization Form (PDF) - last updated Nov 2, 2023 · Outpatient Prior Authorization Form (PDF) ...

Intended use: When an issuer requires prior authorization of a health care service, use this form to request the authorization by mail or fax.

I UNDERSTAND: This may include records involving communicable or venereal disease, psychiatric, drug abuse and/or alcoholism. The information authorized.

17 авг. 2023 г. · Member must be eligible at the time services are rendered. Services must be a covered Health Plan Benefit and medically necessary with prior.

Provider Prior Authorization Form. For providers to submit prior authorization requests, provide clinical information, and receive determination outcomes ...