Health Care Partners Authorization Form - Web • print where you want your health information sent (e.g., individual, business, other healthcare facility). Web forms for submitting prior authorization requests sign in to check the status of your prior authorization request and select. Hepatitis c medication request form (pdf) c. Prior authorization / exception form (pdf) b. Web pharmacy prior authorization/exception request form (pdf) travel benefit claim form (pdf) (certain plans only) you can also. Prior authorization requests may also be submitted via fax.
Prior authorization requests may also be submitted via fax. Hepatitis c medication request form (pdf) c. Web • print where you want your health information sent (e.g., individual, business, other healthcare facility). Web forms for submitting prior authorization requests sign in to check the status of your prior authorization request and select. Web pharmacy prior authorization/exception request form (pdf) travel benefit claim form (pdf) (certain plans only) you can also. Prior authorization / exception form (pdf) b.