Forms & publications
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Prescription Drug Expedited Authorization (EA) List (2021-12-01)
Prescription Drug Expedited Authorization (EA) List (2022-06-01)
Prior Authorization Direct Data Entry (DDE) submission for dental providers
Step-by-step resource for entering dental authorizations through the provider portal in ProviderOne.
Prior Authorization Direct Data Entry (DDE) submission for DME providers
Step-by-step resource for entering DME authorizations through the provider portal in ProviderOne.
Prior Authorization Direct Data Entry (DDE) submission for medical providers
Step-by-step resource for entering medical authorizations through the provider portal in ProviderOne.
Prior authorization for sign language request
Presentation slides from January 2022 on Prior authorization for sign language requests.
Prior authorization pend forms submission cover sheet
Use this submission cover sheet for prior authorization requests for nonpharmacy claims submissions.
ProviderOne billing and resource guide
A complete guide to working in ProviderOne, from checking eligibility, submitting authorization, and submitting direct data entry (DDE) claims.
Removable prosthetic prior authorization form
Removable prosthetic prior authorization form.
Download Removable prosthetic prior authorization form
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