Medical Authorization Forms
Last Updated: Tuesday, February 28, 2023
This page contains medical authorization forms for providers to use when communicating with Highmark.
- wpa/ nepa
- cpa/ sepa
- de
- neny
- wny
- wv
For Members
Some types of health care services and supplies require prior authorization from Highmark before you can receive them. For additional information on prior authorization click Authorization Guidance.
Forms Removed
Effective July 1, 2024, West Virginia Law (Senate Bill 267) mandates the electronic submission of prior authorization requests. For this reason, Highmark removed West Virginia prior authorization forms from the Provider Resource Center (PRC). All prior authorization requests must now be submitted to Highmark via our provider portal (Availity®).
Related Links
Pharmacy Prior Authorization Forms
Find additional information and updates in our monthly newsletter, Provider News:
Availity’s multi-payer platform will support the existing payer-provider transactions necessary to manage care for Highmark members.
