There are two options for submitting a UM Prior Authorization Request.
Option 1:
Submit here, 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