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  • Trillium Outpatient Prior Authorization Fax Form

Get Trillium Outpatient Prior Authorization Fax Form

TRILLIUM OUTPATIENT PRIOR AUTHORIZATION FAX FORM Request for additional units. Existing Authorization Standard Request Complete and Fax to: (844) 3717765 Medicare (541) 4850737 Medicaid (844) 2072459.

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Have your doctor fax in completed forms at 1-877-243-6930.

If you think more information or an additional form may be needed, please check the issuer's website before faxing or mailing your request. Please fax form to Superior HealthPlan at 1-866-399-0929.

Prior authorization requests should be faxed to the Precertification Operations Department at 888-415-9055 (Tufts Health Together, Tufts Health Direct), 857-304-6304 (Tufts Health Unify) or 857-304-6404 (Tufts Health RITogether).

Trillium Community Health Plan payor ID number is 68069.

If you think more information or an additional form may be needed, please check the issuer's website before faxing or mailing your request. Please fax form to Superior HealthPlan at 1-866-399-0929.

If you have questions, please call Service Coordination toll-free at 1-877-301-4394.

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.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
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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
Content Takedown 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