Change an existing authorization

Doctor or facility change: Fax a new or updated prior authorization form. Mark the form "Change to existing authorization."

Procedure or diagnosis code changes: Fax a new or updated prior authorization form. Mark the form "Change to existing authorization."

Date change: 

Authorization forms

Drug prior authorization forms

Medical/service/device authorization forms

Save time, request a provider account

Out-of-network? You can still get access to our time-saving online tools, including a secure Mailbox. For auth date changes, you can go to your Mailbox, compose a message. Choose "Medical Auth Update" for the "To" address. Include the member name and ID number as well as the authorization number. Faxes are not accepted. 

Request a provider account