Get Online Provider Tools Update - 11/06 - Hmsa.com

Filling out the Online Provider Tools Update form is essential for ensuring accurate and timely communication regarding prior authorizations. This guide will walk you through each section of the form, providing clear, step-by-step instructions to ensure all necessary information is submitted correctly.

Follow the steps to complete your form successfully.

1. Press the ‘Get Form’ button to retrieve the form and access it for completion.
2. Begin by filling out the patient information section. Include the patient's name, ID, group number, date of birth, and phone number. This information is crucial for identification and verification purposes.
3. In the prescribing physician section, provide the physician's name, phone number, fax number, and address, including city, state, and zip code. This ensures that the relevant healthcare provider is associated with the authorization request.
4. Detail the diagnosis by including the condition for which the prior authorization is being requested, along with the appropriate ICD code. This helps in assessing the eligibility for coverage.
5. Proceed to the questions section, where you will circle the 'yes' or 'no' answers for each provided question. Make sure to respond accurately based on the patient's medical history.
6. Ensure you provide any necessary comments that might provide additional insights regarding the patient's condition and treatment considerations.
7. Finally, affirm the accuracy of the information provided by signing and dating the form. This is a critical step to validate your submission before it is sent out.
8. Once all sections are complete and validated, you can save changes, download, print, or share the form for faxing to CVS/Caremark at 1-855-762-5206.

Complete your documents online today to ensure timely processing of your prior authorization requests.