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Priority Partners Forms
Priority Partners provides immediate access to required forms and documents to assist our providers in expediting claims processing, prior authorizations, referrals, credentialing and more.
- Behavioral Health Services Referral
- Care Management Services Request
- Maryland Uniform Credentialing
- Member Services Referral
- Newborn Enrollment Notification
- Pharmacy Compound Prior Authorization Request
- Pharmacy Hepatitis C Therapy Prior Authorization Request
- Pharmacy Opioid Prior Authorization Request
- Pharmacy Makena Processing and Prior Authorization Request
- Pharmacy Prior Authorization Request (non-opioid medications only)
- Pharmacy Synagis Prior Authorization Request
- Primary Care Provider Change
- Provider Update
- Rejection Review - Appeals
- Same Day Pre-Authorization Request
PLEASE NOTE: All forms are required to be faxed to Priority Partners for processing. See the fax number at the top of the each form for proper submission. If you have any questions, please contact Customer Service at 1-800-654-9728.