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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
- Compound Prior Authorization Request
- Hepatitis C Therapy Prior Authorization Request
- Long Acting Opioid Prior Authorization Request - effective 1/1/17
- Makena Processing and Prior Authorization Request
- Maryland Uniform Credentialing
- Member Services Referral
- Newborn Enrollment Notification
- Pharmacy Pre-Authorization Request
- Primary Care Provider Change
- Provider Update
- Rejection Review - Appeals
- Same Day Pre-Authorization Request
- Synagis Prior 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.