Contact the Pharmacy Dept at: (410) 424-4490, option 4 or . If you want a friend, relative, your doctor or other provider, or other person to be your representative, fill . Claims & Appeals Submission Billing Address Johns Hopkins HealthCare LLC Attn: Priority Partners Claims 6704 Curtis Court Glen Burnie, MD 21060 Claims must be submitted on CMS 1500 or UB-04 forms in processing this request, please ensure that contact information is accurate in case : additional information is required. Frequently Asked Questions About the Changes Effective . Follow the step-by-step instructions below to eSign your priority partners prior auth form: Select the document you want to sign and click Upload. Under Medicare Part C (Medicare Advantage) rules, once a service has been rendered without obtaining prior authorization, it is considered to be post-service even if we have not received a claim. The adult representative can only be the minor's parent, step-parent, legal guardian, or kinship caregiver. Health Partners Dme Prior Auth Form. Comply with our simple steps to have your Priority Partners Prior Auth Form prepared quickly: Choose the web sample in the library. Our state online blanks and simple instructions eliminate human-prone faults. Find trusted in-network doctors, covered prescriptions and get plan information. Services Not Prior Approved By HCP, MSO Are Not Payable * IMPORTANT NOTE TO HCP CONTRACTED AND NON-CONTRACTED PROVIDERS. Fax the request form to 888.647.6152. See reconsideration/appeals under Medicare for more information. A Priority Partners prior authorization form allows a medical . Transplant Checklist - eForm. To request a paper copy, please call Customer Service at 800-654-9728 (TTY for the hearing impaired: 888-232-0488 ). authorization or medical review, please refer to the Outpatient Referral and Pre-Authorization Guidelines at www.jhhc.com. This includes drugs to be administered directly to a member by a medical healthcare provider (hospitals, surgery centers, prescriber offices, and clinics). icon-undo Create your signature and click Ok. Press Done. 2021 HealthCare Partners, MSO. Prior Authorization Forms. Something went wrong. Pre-authorization reconsideration request? For questions, please call the Medical Management Department at (800) 250-6647 or (480) 400-0027. Document this conversation in the patient's record. Ensures that a website is free of malware attacks. Specific IgE Panel Testing Form. There are three variants; a typed, drawn or uploaded signature. As part of our coverage criteria and drug list (formulary) policies, some services and medicines require prior authorization before our health plans cover them. Optimize your company's health plan. Customize the blanks with smart fillable areas. As a provider outside of Michigan who is not contracted with us, you should submit Medicare authorization requests via fax, using the proper prior authorization form. Learn More about EZ-Net. Decide on what kind of eSignature to create. Request prior authorization for Personal Care Attendant PCA Services. Check out our resources: Optimize your company's health plan. Health (5 days ago) Health Priority Health Medicare prior authorization form Fax completed form to: 877.974.4411 toll free, or 616.942.8206 This form applies to: This request is: Medicare Part B Expedited Healthmoom.com . Check the status of your authorization using the online iExchange portal. Customize the blanks with unique fillable fields. Post-service, you may submit aRequest for Payment. However, with our preconfigured online templates, things get simpler. See reconsideration/appeals under Medicare for more information. Changes to the L.A. Care Direct Network effective November 1st, 2022. Comply with our simple steps to have your Priority Partners Prior Auth Form prepared quickly: Make use of the fast search and innovative cloud editor to create a precise Priority Partners Prior Auth Form. Follow the simple instructions below: The prep of lawful documents can be high-priced and time-consuming. All Medicare authorization requests can be submitted using our general authorization form. Please validate patient eligibility and benefits prior to rendering services. Authorization Request Form FOR EHP, PRIORITY PARTNERS AND USFHP USE ONLY Note: All fields are mandatory. The Centers for Medicare and Medicaid Services (CMS) rules require that all Part C (Medicare Advantage) plans - NOT providers - give a specific written notice to members if a service or item isn't covered. Thanks for working with Priority Health to give our members the right care at the right time. These requirements and procedures for requesting prior authorization should be followed to ensure accurate and timely processing of prior authorization requests. When a service or device is specifically excluded from coverage by the member's Evidence of Coverage document, providers may tell the member that the service will not be covered and the member will be financially responsible for the service or device. Send a completed Authorization Request form to (888) 746-6433 or (516) 746 . hb``pd``Ib```z1GCGG#303|b`X0$X_k .a2M`neMa~\!Pq>g{B9LHH>QY4| t,\^D-! Follow the step-by-step instructions below to design your priority partners authorization form: Select the document you want to sign and click Upload. Learn how to refer your patients to HCP Preferred Specialists and when/if Prior Authorization is needed The member has the right to appeal a denial. Please submit the Reconsideration of a Denied Pre-Authorization form. (6 days ago) DME Authorization Request Form Anyone who misrepresents, falsifies, or conceals essential information required for payment of state and/or federal funds may be subject to fine, . Prior Authorization requests may also be submitted via FAX. It applies to all PartC Medicare Advantage plans. The preferred and most efficient way to submit a Prior Authorization (PA) request is via the HCP Web-based data interface, EZ-Net. Experience a faster way to fill out and sign forms on the web. Our state web-based blanks and crystal-clear instructions remove human-prone mistakes. This is specifically for patients who are Priority Partners members through the John Hopkins Medicine LLC. I want to. If you can't submit a request via telephone, please use our general request form or one of the state specific forms below . Health (1 days ago) Note: Requests for prior . Incomplete requests will be returned. Each FedEx Corporation is an American multinational delivery services company headquartered in Use professional pre-built templates to fill in and sign documents online faster. Box 232 Send a completed Authorization Request form to (888) 746-6433 or (516) 746-6433. Health (9 days ago) The preferred and most efficient way to submit a Prior Authorization (PA) request is via the HCP Web-based data interface, EZ-Net. This is a Part C member right; that is, the member has the right to know if something is or isn't covered. Learn More about EZ-Net. USLegal has been awarded the TopTenREVIEWS Gold Award 9 years in a row as the most comprehensive and helpful online legal forms services on the market today. Certain requests for coverage require review with the prescribing physician. #1 Internet-trusted security seal. USLegal fulfills industry-leading security and compliance standards. Hepatitis C Therapy Prior Authorization Request Medical Review Medical Injectable Prior Authorization Request Member Referral Please submit your request to the fax number listed on the request form with the fax coversheet. Health insurance can be complicatedespecially when it comes to prior authorization (also referred to as pre-approval, pre-authorization and pre-certification). Priority Health, ATTN: Claims The request is reviewed by Priority Health's clinical team. EZ-Net is the preferred and most efficient way to submit a Prior Authorization (PA). Save the ready-made document to your device or print it as a hard copy. Decide on what kind of signature to create. See details. If you want to, you can name another person to act for you as your "representative" to ask for a coverage decision or make an appeal. Get access to thousands of forms. Now, using a Priority Health Prior Authorization takes at most 5 minutes. Health Updated June 02, 2022. All Medicare authorization requests can be submitted using our general authorization form. Priority Partners Sign In will sometimes glitch and take you a long time to try different solutions. Priority Partners SAV-RX SelectHealth Silverscript TRICARE UnitedHealthcare WellCare How to Write Step 1 - At the top of the Global Prescription Drug Prior Authorization Request Form, you will need to provide the name, phone number, and fax number for the "Plan/Medical Group Name." Health (6 days ago) Pharmacy forms HealthPartners. Get your online template and fill it in using progressive features. Find the Priority Health Prior Authorization Form For Medications you need. FAX Completed Form AND APPLICABLE PROGRESS NOTES to: (410) 424-4607 Or (410)424-4751. Maryland Medicaid will require prior authorization for long-acting opioids, form); Feb 18, 2020 Programs, Priority Partners, Advantage MD and US Family Health Plan. Highest customer reviews on one of the most highly-trusted product review platforms. The forms included below are only for claims to be billed as medical claims direct to PHC. Complete all necessary information in the required fillable areas. LoginAsk is here to help you access Priority Partners Sign In quickly and handle each specific case you encounter. Pharmacy General Medical Authorization - eForm. All fields are required for processing your request. Weight Management Request Form. Category: Health Detail Health Quick Links Synagis Enrollment. After this date, letters will no longer be mailed. Request for Prior Authorization Form - Medicaid; For Medical Infusible Medication requests, FAX to (313) 664-5338. Health Partners Medicare Drug-Specific Prior Authorization Forms Use the appropriate request form to help ensure that all necessary information is provided for the requested drug Ask your doctor to fax the form to 888-883-5434 or mail the form If you are not already registered for the web portal, go to the Provider Web . Health 9 hours ago PRIOR AUTHORIZATION REQUEST FORM Praluent - Medicare Phone: 215-991-4300 Fax back to: 866-371-3239 Healthmoom.com Category: Health Detail Health ICP Prior Authorization Form. STANDARDIZED PRIOR AUTHORIZATION REQUEST FORM REFERENCE GUIDE (continued) Author: LMagnant Created Date: 5/1/2012 11:53:27 AM . Please fax to the applicable area: EHP & PP DME: 410-762-5250 Inpatient Medical: 410-424-4894 Outpatient Medical: -762 5205 . Optum Care Prior Authorization Form Form Prior authorization form Use this form in Arizona, Nevada and Utah. Please answer the following questions and fax this form to the number listed above. Send a completed Authorization Requestform to (888) 746-6433 or (516) 746-6433. Health (9 days ago) Ask your doctor to fill in the provider and therapy sections of the form. Submit a Prior Authorization Request - HCP. Advanced Imaging No PSOD or form is needed. Click Done following double-examining all the data. Priority Health will review the member's medical information and CMS rules/regulations to determine coverage and notify both you and the member of our decision. Undo. Filter Type: . Enjoy smart fillable fields and interactivity. Termination of Pregnancy - eForm. We require prior authorization for certain services and procedures. Out-of-network Outpatient Prior Authorization Request Form Today's date / / Fax to: 888-977-0776 Please note: Use this form to request prior authorization for out-of-network (OON) outpatient behavioral. Training video User guide Fax/Phone For all medical specialty drugs, you can use the MA Standardized Prior Authorization form to submit your request to NovoLogix via fax at 844-851-0882. We've provided the following resources to help you understand Anthem's prior authorization process and obtain authorization for your patients when it's . Most office-based services in the PCP setting do not require a prior authorization for reimbursement. Chart notes are required and must be faxed with this request. Login credentials for EZ-Net are required. You may not request a retrospective authorization for Priority Health Medicare Advantage patients. See why we're #1 for individual Medicare Advantage plans in Michigan. Check out our resources. Prior Authorization Request for In-Network Benefits - UnityPoint Employer Group Note: HealthPartners will only approve in-network benefit requests if we can confirm that medically necessary covered care for the condition is not available in the member's network. Overview of Referrals and Prior Authorizations, HCP Preferred Specialists and Centers of Excellence, PCP Services NOT Requiring Prior Authorization, Specialty Care Services NOT Requiring Prior Authorization Preferred Specialists, Prior Authorization Hospital & Facility-Based Services, Prior Authorization Preventive Care Services, Prior Authorization Injectable Medications, Prior Authorization Lab and Pathology Services, Prior Authorization Physical and Occupational Therapy, View an existing Prior Authorization Request. Preventive Screening Services are made available to all patients without Prior Authorization limitations when performed by a PCP or by a Preferred Specialist Network physician. To request prior authorization, you must submit clinical documentation in writing that explains why the proposed procedure or service is medically necessary. Every year, we post details about the prior authorization requests we received the previous year and how we responded to them. Providers may obtain additional information by calling the Pharmacy Services call center at 1-800-537-8862 during the hours of 8 AM to 4:30 PM Monday through Friday. (9 days ago) The preferred and most efficient way to submit a Prior Authorization (PA) request is via the HCP Web-based data interface, EZ-Net. There are two steps in the prior authorization process: Your health care provider submits the request for pre-approval to Priority Health. PRIOR AUTHORIZATION REQUEST FORM Non-formulary drug Phone: 215-991-4300 Fax back to: 866-240-3712 Health Partners Plans manages the pharmacy drug benefit for your patient. Wound/Hyperbaric Authorization Form - eForm. If you are curious about Customize and create a Priority Partners Authorization, here are the simple ways you need to follow: Hit the "Get Form" Button on this page. Fax the request form to 888.647.6152. endstream endobj startxref Listing Websites about Healthcare Partners Prior Authorization Form. Open it using the cloud-based editor and start editing. When an item or service is not specifically excluded from Medicare coverage by the Medicare Advantage plan Evidence of Coverage (EOC) policy document (see a list of EOC exclusions), but you believe it won't be covered by the member's plan: 3. Vision Request Form. 376 0 obj <>stream . . Detail: Visit URL . We received 28,002 prior authorization requests in 2021: Of the 5,621 prior authorization requests we denied in 2021: For more information about prior authorizations (including how to request one), please call Member Services at the number on the back of your member ID card. Grand Rapids, MI 49501. You received from preferred care partners prior authorization form and preferred care partners is intended for occupational therapy criteria were not be initiated by federal medicare fee for. You cannot appeal on behalf of the Priority Health Medicare member. See the list of EOC exclusions. Form must be submitted and request approved prior to obtaining services. Prior Authorization. Smarter health care drives better results. Forms 10/10, Features Set 10/10, Ease of Use 10/10, Customer Service 10/10. 193 0 obj <> endobj Look up plan benefits Complete the empty areas; concerned parties names, places of residence and phone numbers etc. Priority Partners Prior Authorization Form Quickly create a Priority Health Prior Authorization Form without having to involve specialists. All documents are available in paper form without charge. Put the date and place your electronic signature. Our state web-based blanks and crystal-clear instructions remove human-prone mistakes. Vision Request Form - eForm. Prior Authorization requests may also be submitted via FAX. Smarter health care drives better results. health and lives of one million members across Michigan. See the fax number at the top of each form for proper submission. MassHealth (ad hoc), UniCare, Wellpoint, UnitedHealthcare, Partners HealthCare, Winchester Hospital, North Adams Regional Health Center, Jordan Hospital, Harrington Hospital, Baystate Medical Center, . Prior Authorization Guidelines - Health Partners Health (5 days ago) PRIOR AUTHORIZATION REQUIREMENTS To request a prior authorization, contact the HPP Prior Authorization department at 1-866-500-4571 (prompts #2, #3). hbbd```b``9"H3`W0 L`,"H6}0;"`<0"@$Cd1@:XX6DFE$X~XM"|BW_Hd &XXn>9=&=LP fG`r'X$Hu `%GIjsib ) Open the authorization request form printable and follow the instructions Easily sign the authorization request form template with your finger Send filled & signed metroplus authorization request or save Rate the authorization request form sample 4.6 Satisfied 44 votes be ready to get more Create this form in 5 minutes or less Get Form Category: Health View Health . If you have any questions, please contact Customer Service at 1-800-654-9728. Fax the request form to 888.647.6152. Make sure everything is filled in properly, without any typos or absent blocks. Download now Top The PSOD process differs from the rule for fee-for-service Medicare ("Original Medicare") patients, which allows you, the provider, to give written notice. Create your eSignature and click Ok. Press Done. Until further notice, please email all preauthorization requests for professional services, injectable drug, or laboratory service to mdh.preauthfax@maryland.gov . There may be someone who is already legally authorized to act as your representative under State law. 877.974.4411 toll free, or 616.942.8206 This form applies to: This request is: Entyvio Commercial Urgent (life threatening) Medicaid . (9 days ago)PRIOR AUTHORIZATION REQUEST FORM Non-formulary drug Phone: 215-991-4300 Fax back to: 866-240-3712 Health Partners Plans manages the pharmacy drug benefit for your patient. Prior Authorization requests may also be submitted via FAX. The Preferred Method for Prior Authorization Requests CoverMyMeds is the fastest and easiest way to review, complete and track PA requests. Any request that was submitted to the fax number 410-767-6034 on or after December 5, 2021 must be resubmitted to the email address provided above. Download the data file or print out your copy. OPIOID PRIOR AUTHORIZATION FORM: Page 4 of 4: Created Date: 10/20/2017 10:40:23 AM . Please call us at 800.753.2851 to submit a verbal prior authorization request if you are unable to use Electronic Prior Authorization. Add the particular date and place your e-signature. We're a nationally recognized nonprofit health benefits company focused on improving the You can access the NovoLogix online prior authorization tool through the provider portal. Our electronic prior authorization (ePA) solution is HIPAA-compliant and available for all plans and all medications at no cost to providers and their staff. Submission of this completed form certifies that the information is true and accurate. The approval of the services indicated above refers only to the medical appropriateness of the requested service(s)and does not . Prior Authorization Forms and Policies Pre-authorization fax numbers are specific to the type of authorization request. Find a listing of services here that you can perform in your office without a submission request. L.A. Care Direct Network Prior Authorization Fax Request Form, effective 11/1/22. Service code if available (HCPCS/CPT) To better serve our providers, business partners, and patients, the Cigna Coverage Review Department is transitioning from PromptPA, fax, and phone coverage reviews (also called prior authorizations) to Electronic Prior Authorizations (ePAs). . Furthermore, you can find the "Troubleshooting Login Issues" section which can answer your unresolved problems and equip you . Every year, we post details about the prior authorization requests we received the previous year and how we responded to them. Choose My Signature. You can also access many request forms for pharmacy prior authorizations or exceptions in your online account. partners/forms.html Priority Partners provides immediate access to required forms and documents to assist our providers in expediting claims processing, prior authorizations, referrals, credentialing and more. . Send a completed Authorization Request form to (888) 746-6433 or (516) 746-6433. Spinal Cord Simulator Request Form. To notify a patient who is already receiving care in a skilled nursing facility that they no longer need skilled nursing care and it will no longer be covered by their plan, skilled nursing facilities (SNFs) may issue the Notice of Medicare Non-coverage form to Medicare Advantage plan members. LA2629 12/19 AUTHORIZATION REQUEST FORM Please fax completed form to appropriate L.A. Care UM Department fax number listed below: Prior Authorization: 213.438.5777 Urgent: 213.438.6100 Inpatient: Submit all clinical documentation such as progress notes/labs/radiology with requests. Michigan Prior Authorization Request Form for Prescription Drugs; Prescription determination request form for Medicare Part D; For HAP Empowered Medicaid requests, please FAX the following form to (313) 664-5460. Priority Partners Prior (Rx) Authorization Form Updated June 02, 2022 A Priority Partners prior authorization form allows a medical professional to request coverage for a medication that isn't under the medical plan's formulary. Prior Authorization Resources. Step 1 - Download the form in Adobe PDF to begin. Fax all completed Health Partners (Medicaid) and KidzPartners (CHIP) prior authorization request forms to 1-866-240-3712. Payment for services is dependent upon the patient's . enhance our marketing activities (including cooperating with our marketing partners) and for other business use. Wound/Hyperbaric Authorization Form. Use the Direct Network Provider Prior Authorization Tool. Card added. Find out here what requires an authorization and the steps needed to properly fill out and submit your request to HCP. Priority Partners (PP) (888) 819-1043, option 4 (410)-424-4751 . Prior Authorization requests may also be submitted via FAX. CMS wants to be sure Part C plan members know whether they will incur any additional costs other than their plan cost share. Adhere to our simple actions to have your Priority Health Prior Authorization prepared rapidly: Pick the web sample in the library. Login credentials for EZ-Net are required. Step 2 - Once the form is open on your computer, check whether or not the request is urgent or non-urgent. The Part C rule can be found in the Medicare Managed Care Manual, Section 160, Chapter 4,Benefits and Beneficiary Protections. If an expedited request is submitted, a decision will be rendered within 72 hours. The intuitive drag&drop interface makes it simple to include or move fields. HealthCare Partners utilizes a network of thousands of Preferred Specialist providers across its entire geography from Staten Island to Montauk who require NO Prior Authorization or Referral Number to see HealthCare Partners patients in the office setting. Health (7 days ago) Prior Authorization for Durable Medical Equipment. AUTHORIZATION IS CONTINGENT UPON MEMBER'S ELIGIBILITY ON DATE OF SERVICE Do not schedule non-emergent requested service until authorization is obtained. See our high-quality Medicaid plans and understand your coverage. For Additional Forms Click Here. Letters can be viewed and printed in the portal. Now, creating a Priority Partners Prior Auth Form takes a maximum of 5 minutes. NovoLogix customer service: 844-345-2803 We use cookies to improve security, personalize the user experience, enhance our marketing activities (including cooperating with our marketing partners) and for other business use. Access the providers' prior authorization form to seek approval to prescribe medications for your patients. Health (9 days ago) . TopTenReviews wrote "there is such an extensive range of documents covering so many topics that it is unlikely you would need to look anywhere else". Spinal Cord Simulator - eForm. Claim submitted: We have made a decision if your claim was submitted. Weight Management - eForm. Health Partners Prior Authorization Form Pdf. Prior authorization reporting As part of our coverage criteria and drug list (formulary) policies, some services and medicines require prior authorization before our health plans cover them. For standard requests, a decision will be made within 14 days. Explain to the member that he or she will have to pay 100% of the cost of any medical services that Medicare doesn't cover. Partners, MSO AUTHORIZATION REQUEST . Learn More about EZ-Net. Type all necessary information in the necessary fillable fields. Free Priority Partners Prior (Rx) Authorization Form PDF - EForms. All rights reserved, View an Existing Prior Authorization Request, Claims Submission for EmblemHealth Patients, Claims Submission for Empire Medicare Advantage Patients, Claims Submission for All Other HCP Patients, Update Your Practice Demographic Information, Group Medical and Office Supplies Discounts, Contact your Provider Relations Specialist, Benefits of HealthCare Partners, IPA Membership, Coronavirus (COVID-19): Information for Members, Were here to help you deliver great care, Were here to support your financial success, Were here to ease your administrative burdens. 0 Submit form by: For group numbers that begin with IFB or B: Fax to 952-992-2836 or E-Mail to ifbhealthmanagement@medica.com Login credentials for EZ-Net are required. In some cases, a prior authorization may be required. Whether or not the member requests a PSOD, the member can't be held financially responsible for a non-covered service unless there's a clear exclusion in the member's Evidence of Coverage (EOC) plan document, OR Priority Health issues a Notice of Denial of Medicare Coverage. PriorityHealth Prior Prescription (Rx) Authorization Form. *Please submit clinical information to support this request* Provider's Signature: _____ Date: _____ Primary Care Providers (PCPs) and Specialists should refer to . Priority Health Prior Auth Form. Please answer the following questions and fax this form to the number listed above. About CoverMyMeds Provider Claims/Payment Dispute and Correspondence Submission Form PLEASE NOTE: All forms are required to be faxed to Priority Partners for processing. Most office-based services performed at a preferred specialist do not require a prior authorization for reimbursement. Choose My Signature. Claim Adjustment Requests - online Add new data or change originally submitted data on a claim Claim Adjustment Request - fax Claim Appeal Requests - online Reconsideration of originally submitted claim data Claim Appeal Form - fax Claim Attachment Submissions - online Dental Claim Attachment - fax Medical Claim Attachment - fax ePAs save time and help patients receive their medications faster. A separate form is available for non-drug per diem codes allowed for . Tackling health equity through Priority Health for Good, See reconsideration/appeals under Medicare for more information. If your health plan's formulary guide indicates that you need a Prior Authorization for a specific drug, your physician must submit a prior authorization request form to the health plan for approval. Login credentials for EZ-Net are required. Find a listing of services here that Preferred Specialists can perform without submitting a request. We strongly encourage providers to engage with every patient annually to ensure their health and wellness initiatives are kept current. Guarantees that a business meets BBB accreditation standards in the US and Canada. Pharmacy Prior Authorization Form. @ 3% 2022 Priority Health, a Michigan company. The Guide of completing Priority Partners Authorization Online. If the member refuses, document the refusal in the medical record. Prior Authorization criteria is available upon request. Wherever your client may be in their health care journey, there's a product to meet their unique needs. Medical Necessity Review/Prior Authorization Request Form Fax: 866-337-8690 **PLEASE PRINT** Updated 2/9/2021 Page 2 of **PLEASE PRINT** SUPPORTING DOCUMENTATION Only submit clinical information that supports the request for service(s) to determine medical necessity or specifically requested by eQHealth Solutions. Oops! All Medicare authorization requests can be submitted using our general authorization form. Complete Entyvio Prior Authorization Form - Priority Health online with US Legal Forms. %PDF-1.6 % There are three variants; a typed, drawn or uploaded signature. PA#: Date Entered: Questions? Submit a Prior Authorization Request - HCP. Certain requests for coverage require review with the prescribing physician. 260 0 obj <>/Filter/FlateDecode/ID[<28E4A798A1D94F468D438B42CBD41FBC>]/Index[193 184]/Info 192 0 R/Length 243/Prev 254195/Root 194 0 R/Size 377/Type/XRef/W[1 3 1]>>stream Wait in a petient way for the upload of your Priority Partners Authorization. Login credentials for EZ-Net are required. Effective October 31, 2020, PrimeWest Health Service Authorization requests and notifications must be submitted online through the PrimeWest Health provider web portal.
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