Behavioral Health Administrative Services Organization contacts for providers
Behavioral Health Administrative Services Organization contacts for providers including general inquiries, authorizations, and crisis lines.
Forms & publications
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Billing with two authorization numbers
A guide to assist with billing two authorization numbers on a claim.
Burosumab-twza (Crysvita) authorization request
Check the status of an authorization using the ProviderOne portal
A step-by-step guide for providers to check the status of an authorization using the ProviderOne portal.
Compression garments authorization form (13-871)
Use this form to request and provide medical justification for compression garments.
Download Compression garments authorization form (13-871)
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Corneal cross linking prior authorization
CUP women program preauthorization for limitation extension
Form for CUP women program preauthorization for limitation extension.
Elapegademase-lvlr (Revcovi) authorization request
Enteral nutrition products prescription form (oral enteral nutrition)
A typed and completed General Authorization for Information form must be the cover sheet for your request in order to be processed by the Health Care Authority.
Exondys 51 request form
Use this form to request prior authorization to prescribe Exondys 51 (eteplirsen).
Download Exondys 51 request form
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