Highmark Outpatient Authorization Form

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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. If you are requesting a drug that requires a prior authorization or step therapy, please complete the drug specific prior. Web highmark blue shield medical management and policy department outpatient authorization request form submission.

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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 authorization request form submission instructions: 888.236.6321 or 800.670.4862 (delaware) inpatient: Find a doc or rx. Complete and fax all requested information below including any supporting.

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