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Care1st Internal Use Sub #: DOE: Medication Prior Authorization Form IPA: Pharmacy Department Fax: (323) 889-6254 or (866) 712-2731 LOB: Instructions: This form is to be used by participating physicians.

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Related content

Prior Authorization Forms - ahcccs
Contacts. You may fax the Fee For Service Prior Authorization Request Form to the AHCCCS...
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[PDF] Plan Booklet
These benefits are issued under policy form numbers: ... prior authorization from...
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Related links form

New York State Department Of Taxation And Finance Amended Nonresident And Part-Year Resident Income IT-2 New York State Department Of Taxation And Finance Summary Of Federal Form W-2 Statements New 2007 , Claim For New York City School Tax Credit, NYC210 - Tax Ny IT-215 New York State Department Of Taxation And Finance Claim For Earned Income Credit New York

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If your health care provider is in-network, they will start the prior authorization process. If you don't use a health care provider in your plan's network, then you are responsible for obtaining the prior authorization.

To get answers to Fee for Service claims questions, you may do the following: Submit a ticket to servicedesk@azahcccs.gov. ... Call (602) 417-7670 and follow the prompt to speak to a Provider Services representative.

Care1st Health Plan Arizona and WellCare are wholly owned subsidiaries of Centene Corporation, a leading multi-national healthcare enterprise committed to helping people live healthier lives.

Prior Authorization Request Submission Process via Telephone (reserved for urgent requests after submitting documents through AHCCCS Online Provider Portal or hospital discharges) 1-602-417-7670 (Provider Services) 1-800-523-0231 (Out of state line to AHCCCS switchboard; dial extension 6024174400 or ask for PA area)

Payer Name: Care1st Health Plan of CA|Payer ID: C1SCA|Professional (CMS1500)/Institutional (UB04)[Hospitals]

Our Provider Services representatives are skilled to provide help to many basic prior authorization questions. To reach Provider Services call (602) 417-7670. Provider Services Operation Hours: Monday-Friday from 7:30 A.M. - 5:00 P.M.

Prior Authorization Request Submission Process via Telephone (reserved for urgent requests after submitting documents through AHCCCS Online Provider Portal or hospital discharges) 1-602-417-7670 (Provider Services) 1-800-523-0231 (Out of state line to AHCCCS switchboard; dial extension 6024174400 or ask for PA area)

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232