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  • La Care Authorization Form

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L.A. Care Use Only L.A. CARE HEALTH PLAN PRE-AUTHORIZATION REQUEST FORM If the treating physician would like to discuss this case with the physician reviewer or obtain a copy of the criteria used.

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Fax: 213-438-2201 Use our code look-up tool https://.lacare.org/providers/provider-resources/prior-authorization-search Any questions?

The GHPP is a prior authorization program. This means that a Service Authorization Request (SAR) must be submitted to the GHPP State office for approval for all diagnostic and treatments services, except for emergencies.

Fax W-9 Form (without paper claim) to 213-438-5732.

For questions about pre-approval (prior authorization), call Member Services at 1-888-839-9909 (TTY 711).

The requested clinical should be faxed to Medical Management, using the appropriate fax number for the service for which authorization is requested. Medicaid Prior Authorization Fax Numbers: Physical Health: 1-800-690-7030. Behavioral Health: 866-570-7517.

Timely Access to Care APPOINTMENT TYPEMUST GET APPOINTMENT WITHINUrgent care appointments that do not require pre-approval (prior authorization)48 hoursUrgent care appointments that do require pre-approval (prior authorization)96 hoursNon-urgent (routine) primary care appointments10 business days4 more rows

Call us today at 1-888-4LA-CARE (1-888-452-2273) to apply for health care coverage. L.A. Care Health Plan representatives are available 24 hours a day, 7 days a week, including holidays to help you.

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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
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
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