Pacific Health Alliance Auth Form - If medical records are not received, it will not be reviewed. The nurse line is available to members 24 hours per day, 365 days a year. Web pha offers clients nationwide access to over 3700 hospitals and 400,000 physicians. We strongly recommend calling our um department for urgent requests. Web pacific alliance medical group form. Please complete the form in its entirety. Pacific health alliance nurse line is part of the care counseling service. All tax i.d./ cpt codes must be completed. Medical prior authorization request form. The pha network can handle all of your local.
Web pacific alliance medical group form. Please complete the form in its entirety. Health alliance credentialing application (for contracted midlevel providers) caqh provider addition form (for il contracted mds and dos only) ancillary facility checklist. Members have access to care advisors to help them with symptoms or answer health related questions. All tax i.d./ cpt codes must be completed. We strongly recommend calling our um department for urgent requests. Once the form has been received in our office the pha staff will process all requests in the order they are submitted. Our advisors have an average of 18 years clinical experience and services. Pacific health alliance nurse line is part of the care counseling service. Provider contact information (failure to provide may result in delays) The nurse line is available to members 24 hours per day, 365 days a year. If medical records are not received, it will not be reviewed. Web time frame may seriously jeopardize the member’s life, health or ability to regain maximum function. Web pha offers clients nationwide access to over 3700 hospitals and 400,000 physicians. The pha network can handle all of your local. Medical prior authorization request form.