Provider Registration

The Portal can be used to submit prior authorizations request(s),check authuorization status ,upload clinical documenation to support the request ,download and print determination letters ,etc. A step by step guide to access the portal is available on the UM page, please do not hesitate to contact the Utilization Management or Provider Relations staff for questions, comments, etc. Your assistance in this matter is greatly appreciated.

Users should only request access for the facility or provider you are employed by.

Click the button below to add additional providers or facilities.


Only 6 additional providers or facilities can be added. If more than 6 are required an additional submission will be required after this form is submitted.