Health Management Provider Resources
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Prior Authorization Requests
For prior authorization, please complete the Request For Medical Necessity Determination form. You must verify benefits and eligibility prior to submission. Incomplete forms cannot be processed.
After completing the form, fax request and clinical documentation to this secure fax at 281-809-6760.
When using a paper request form, please fill it out completely, attach the clinical information, and send it by fax.
Fax Number: 281-809-6760
Medical Helpline Maternity Helpline Form
Help us better support your patients by providing key details about their maternity care needs. Download and complete the Maternity Helpline form below.
Medical Helpline Transition of Care Form
Ensure a seamless care experience for your patients by sharing information about their transition of care needs. Download and complete the Transition of Care form below.
