Behavioral Health Forms

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 prior authorization forms from the West Virginia Provider Resource Center (PRC). All prior authorization requests must now be submitted to Highmark via our provider portal (Availity®).

For more information, read our Provider News article.

 

Use the following template when a member is being discharged:

Last updated on 6/28/2024 3:42:10 PM

 

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