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Baylor Scott & White Health Scott & White Health Plan Health Services Department 1206 West Campus Drive Temple, Texas 76502 Phone#: 18883167947 Fax#: 18006263042 PRIOR AUTHORIZATION FAX COVER SHEET
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How to fill out swhp prior authorization fax
How to fill out swhp prior authorization fax
01
To fill out the SWHP prior authorization fax, follow these steps:
02
Start by downloading the SWHP prior authorization form from the official SWHP website.
03
Fill in the patient's information, including their name, date of birth, and contact details.
04
Provide the healthcare provider's information, such as their name, clinic name, and contact information.
05
Indicate the service or procedure for which prior authorization is being requested.
06
Include the relevant diagnosis codes and CPT codes for the service or procedure.
07
Provide any supporting documentation or medical records that might be required.
08
Complete any additional sections or questions that are specific to the requested service.
09
Sign and date the authorization form.
10
Fax the completed form to the designated SWHP fax number.
11
Keep a copy of the fax transmission confirmation for your records.
Who needs swhp prior authorization fax?
01
Individuals who are seeking healthcare services that require prior authorization from SWHP need to complete and submit the SWHP prior authorization fax. This includes patients who wish to receive services or procedures that are not covered by SWHP in their standard benefits package, or those services that require additional documentation or review before approval.
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