WebIf you need certain types of covered services or supplies, you must get approval in advance through your Primary Care Physician (PCP). When your PCP thinks you need specialized … WebAuthorization/Referral Request Form . Please complete all fields on this form and be sure to include an area code along with your telephone and fax numbers. To verify benefits, call: commercial – 800-448-6262, Medicare – 800-457-4708, Florida Medicaid – 800-477-6931, Kentucky Medicaid – 800-444-9137. F

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OPTIMUM CHOICE, Inc. Preferred Plan 1IT

WebOverview of Optimum Choice United Healthcare OCI HMO OCI is a referral-based plan in which members work closely with a primary care physician (PCP) for appropriate, cost … WebPlease include your provider name, TIN, NPI (s), contact name and phone number. SUD providers and mental health providers who deliver substance use treatment to a participant are reminded to ensure that participants have had the opportunity to sign the Managed Care Organization (MCO) ROI form. WebPRE-CERTIFICATION REQUEST FORM . All REQUIRE MEDICAL RECORDS TO BE ATTACHED . Phone: 888-796-0947 Fax: 866-608-9860 or 888-202-1940 . Instructions: This form is for pre-certification requests which will be processed as quickly as possible depending on the member’s health condition. Do not write STAT, ASAP, Immediate, etc. on this form. shunting an officer