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

Referral Request Form. (Service ... Documentation not included in the referral request form that supports the medically necessity of the requested services.

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

Benefit Elevation Request Form. Online Form - Benefit Elevation Request Form. youtube. RESOURCES. RESOURCES. Ascension Network · Automated Benefit Services.

Please fax your post-service appeal or 2nd level appeal with this form to: 586-238-4363. You may also mail your post service appeal to: Appeals Department ...

As such, we will accept an automatic referral if the following is met: (1) none of the Exclusionary Criterion outlined below is applicable to the patient;. (2) ...

Here you can join the Ascension network, find our medical policies, access provider forms, and stay up to date on the latest news. Prior Authorization · Claims · Ascension Rx Provider · Join the Ascension Network

Get the forms and resources you need for things like LIN access, Prior Authorization and more. You can easily find and download what you need.

This claim form can be used to request reimbursement of covered expenses. Please check which reason applies. (at least one must be checked): PARTICIPANT ...

Locate information about your SmartHealth plan including dental and vision coverage, pharmacy benefits, plan documents, and spending accounts. Provider Resources · Find A Doctor · Member Resources · Plan Coverage