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  • Authorization Request Bformb - Provider Resource Center

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TexanPlus HMO P.O. Box 740444 Houston, TX 772740444 DATE: Fax to: 7139732193 Phone: 7134073021 or 713 4073015 Authorization Request Form IPA/LPO This request will be treated as per the standard organization.

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eviCore healthcare will render a decision on a routine prior authorization request within 14 calendar days of the original request. However, the usual turnaround time is a few days.

Customer Service LocationPhone NumberDaysPittsburgh Service Center 120 Fifth Avenue Place Pittsburgh, PA 15222800-816-5527Monday - FridayJohnstown Service Center 1 Pasquerilla Plaza Johnstown, PA 15901800-816-5527Monday - FridayErie Service Center 717 State Street Erie, PA 16501800-816-5527Monday - Friday

eviCore is a medical benefits management company who works with health plans to help their members, like you, avoid unnecessary care that is costly and potentially unsafe. We do that by applying the latest evidence-based medical guidelines through a process referred to as prior authorization.

Please contact us at (800) 918-8924 to change the CPT code on your request. You can also email our team at webcontactrequests@evicore.com.

Simply visit the eviCore's Provider's Hub page and select the health plan and solution option for your case in the training section. The instructions on how to submit a case and a link to the correct portal to use will be provided.

Highmark has contracted with eviCore to manage molecular and genomic testing and will adopt eviCore's molecular and genomic testing policies.

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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
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