These are requests that we need records for a prior authorization or appeal.

Complete Electronic Form

We have electronic versions of our fax forms that can be completed by clicking on the ticket.

1. Hit "Edit" on the top right of the form and answer the questions.
2. Hit "Submit"
3. After adding any additional documentation, hit "Notes Uploaded" on the right of the screen.

Fax Records

You can fax the records directly to us at 888-286-3058.

1. Complete the questionnaire (If applicable, not all will have one) and or submit medical records (e.g. last office visit, labs, etc.).  

Online Questions

This is the quickest way to complete prior authorization requests. 

• Answer questions online.
• Takes no more than 30 seconds.

Fax Records

Very fast to complete. Send us either:

• Copy of the last office visit or other relevant records
• Answer the questionnaire

Upload Records

You can upload documents through the online portal.

1. Hit the paper clip to the right of the comment box.
2. Select the file you wish to upload.
3. After adding all information, hit "Notes Uploaded" on the right of the screen.

Copy Records From EMR

Records can be copied directly from your EMR.

• Can be done online.
• Takes no more than 30 seconds.