There are two options for submitting a UM Prior Authorization Request


Option 1: Submit using the UM Prior Authorization Request Online Form 

 

Option 2: Complete and fax a UM Prior Authorization Request PDF Form below

  • Fax Inpatient requests to: 303-602-2127

  • Fax Outpatient requests to: 303-602-2128

  • Fax Urgent/Expedited requests to: 303-602-2160