Transcription of Indiana Health Coverage Programs Prior Authorization ...
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Indiana Health Coverage Programs Prior Authorization ...
IHCP Prior Authorization request Form Page 1 of 1 Version , June 15, 2017 Indiana Health Coverage Programs Prior Authorization request Form Fee-for-Service Cooperative Managed Care Services (CMCS) P: 800-269-5720 F: 800-689-2759 Hoosier Healthwise Anthem Hoosier Healthwise P: 866-408-6132 F: 866-406-2803 Anthem Hoosier Healthwise SFHN P: 800-291-4140 F: 800-747-3693 CareSource Hoosier Healthwise P: 844-607-2831 F: 844-432-8924 MDwise Hoosier Healthwise See MHS Hoosier Healthwise P: 877-647-4848 F: 866-912-4245 Healthy Indiana Plan (HIP) Anthem HIP P: 1-844-533-1995 F: 866-406-2803 CareSource HIP P: 844-607-2831 F: 844-432-8924 MDwise HIP See MHS HIP P: 877-647-4848 F: 866-912-4245 Hoosier Care Connect Anthem Hoosier Care Connect P: 1-844-284-1798 F: 866-406-2803 MHS Hoosier Care Co
IHCP Prior Authorization Request Form Page 1 of 1
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