Highmark Outpatient Authorization Form

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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 manuals medical policy search esubscribe requiring authorization pharmacy policy search medical injectable drug forms medical specialty drug. Web home health the ordering provider is typically responsible for obtaining authorizations for the procedures/services included on the list of procedures/dme requiring. Web highmark transitioning from navinet to availity starting in october 2023.

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Web outpatient therapy services prior authorization request form use this form for all physical, occupational, speech, and feeding therapies, pulmonary and cardiac. Highmark blue cross blue shield, highmark choice company, highmark health insurance company, highmark coverage advantage,. 888.236.6321 or 800.670.4862 (delaware) inpatient: Only one patient per fax.

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