Updated July 27, 2023
A Health Net prior authorization form is a document that medical offices will use when requesting coverage of a patient’s prescription. Certain insurance policies may not cover all prescriptions, usually, those that are highly expensive, thus approval from Health Net must be received before a prescription can be written. This form needs to be filled in by the medical staff and submitted to Health Net for review.
- Arizona DME Fax Request: DME 1 (800) 916-8996
- Arizona General PA: 1 (800) 840-109
- California Request: Fax 1 (800) 793-4473 or call 1 (800) 672-2135
- Oregon/WA Medicare Fax Request: 1 (866) 295-8562
- Oregon/WA Commercial Fax Request: 1 (800) 495-1148