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  • Authorization Referral Form - Meridian Health Plan

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Illinois Referral Form Date: / / Fax all authorizations and clinical information to: 312-980-0444 NPI #: TID #: PCP REFERRED BY PATIENT INFORMATION Last Name : Phone: ( First Name: ) - Last Name :.

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hello! We are Meridian. We offer Medicaid and Medicare-Medicaid managed care plans to people in Illinois. Since 2008, we have supported families, children, seniors and people with complex medical needs. We connect our members to the care they need and the benefits they want.

Please call Meridian Provider Services at 866-606-3700.

Phone: 866-984-6462 Fax: 877-355-8070. ... Requestor Information. ... Diagnosis and Medical Information. ... You must include all necessary clinical documentation, office notes and all related laboratory results to ensure a complete PA review.

Contact Us Phone. Members: 1-855-580-1689 (TTY 711) Monday-Friday, 8am to 8pm CST. ... Email. Members: memberservices.il@mhplan.com. Mail. Meridian Medicare-Medicaid Plan (MMP) 1 Campus Martius, Suite 700. ... Legal. Please direct all legal matters to: Attn: Legal.

Does MeridianHealth cover chiropractic services? Yes, MeridianHealth covers chiropractic services for members of all ages.

Some prescriptions and over-the-counter medicines require prior authorization for Medicaid reimbursement. Depending upon the drug, either the prescribing physician or the dispensing pharmacist may submit the request.

HealthChoice Illinois is the statewide Medicaid managed care program. Most Medicaid customers are required to choose a primary care provider (PCP) and health plan. We can help you understand your plan choices, find providers and enroll.

You do not need a paper referral from Meridian to see a provider but your provider may need to request a prior authorization from Meridian for a service to be approved. The recently passed Prior Authorization Reform Act is helping us make our services even better.

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© Copyright 1997-2025
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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