Existing Referral/Authorization Modification Forms

Please note this is not for submitting a new authorization.

1- If your request is for authorization status, please check the notification center

2- If you’re having issues with your provider portal access, please contact the provider relations specialists at (619) 240-8933 for further assistance

3- If you have a question about services that do NOT require an authorization, please click on the following link: Services That Do Not Require Prior Authorization (Tab 2)

4- If you have a question about services that do require an authorization, please click on the following link: Services That Require Prior Authorization (Tab 3)

5- For any other questions or requests, please chose from the list below:

Provider Email Forms

• Request to update rendering/refer to provider
• Add or change CPT codes in existing authorization
• Request to Change the Facility
• Add/Change Diagnosis Code
• Other Requests