Prior Authorization Forms

Pre-authorization fax numbers are specific to the type of authorization request. Please submit your request to the fax number listed on the request form with the fax coversheet.

Pre-authorization reconsideration request? Please submit the Reconsideration of a Denied Pre-Authorization form.

Looking for Optima Health Community Care or Optima Community Complete provider forms? Access OHCC/OCC Authorization forms.

Are you an OhioHealth Provider? Access OhioHealthy Prior Authorization forms.