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Skip Navigation LinksHome > PPO Network > for Providers > Reference Materials > Pre-authorization Form

Pre-authorization Form

A generic authorization form is available that can be used for most Health Plans and Payors.

To determine whether or not pre-authorization or certification is required, you can reference First Choice Health PPO Network (FCH PPO) List of Payors (Yellow Pages). Locate the Payor on the left and in the right hand column, you will find information on who to contact regarding specific details on pre-authorization.

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