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Get Humana Orthonet Pain Management Form

For Humana members. 2. Please complete and Fax this request form along with all supporting clinical documentation to OrthoNet at 1-888-605-5345. (This completed form should be page 1 of the Fax.) 3. For assistance in completing this form or if you should have any question about whether or not the procedure requires prior authorization, please contact OrthoNet toll free at 1-888-605-5344 for Pain Management and at 1-866-565-4733 for Spinal Surgery procedures. 4. Please PRINT, in black ink, one c.

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