First Choice Health Home : Medical Management : Online Forms

Welcome to First Choice Medical Management Pre-Authorization Requirements and Online Tools

Group Search

Please select the group to view pre-authorization requirements. If the group does not appear please refer to the ID card for the benefits and eligibility phone number to access the appropriate medical management company.

Online Forms

Forms are available by clicking the links below. Requests are submitted electronically and you will receive an email confirmation that your request was received.

To request pre-authorization please select the following form:
Pre-authorization Request Form

To refer a participant for catastrophic or complex case management please select the following form:
Case Management Referral Form

To submit additional or updated information regarding ongoing mental health treatments please select the following form:
Request for Outpatient Mental Health Treatment – Concurrent Review