Prior Authorization / Pre-Certification Management Services

Initial Request Form

Contact us @214-613-2019 or complete the form below to request management of a prior authorization/precertification request, and a Prime Care Health Solutions team member will reach out to you to complete your request.

Prior Authorization (PA) Management Initial Request Form

Step 1 of 4

  • Referring Physician or Provider Information

    Provide information about the provider requesting the referral.