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Individuals & Families Medical Dental Vision Short-Term Accident and Critical Illness Life
Medicare Medicare Advantage Plans with Prescription Drug Medicare Supplement Insurance Plans Find the Plan that Fits Your Needs
Employers Health Life and Disability Dental Vision Accident, Critical Illness and Hospital Indemnity Consumer-driven Health Products Federal Employees Health Benefits Program

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In the News
Policies and Standards Accessibility Standards Clinical Practice Guidelines Corporate Medical Policies Corporate Reimbursement Policies Medical Drug Management Medical Necessity Criteria and Clinical Review Guidelines Prescription Drug Resources Prior Approval and Investigational Services
Resources Chronic Condition Management Program Claims Edit System Clinical Supply Materials Continuity and Coordination of Care Credentialing Cultural Competency Resources EFT and ERA First tier, Downstream or Related Entities Forms Healthcare Technology Assessment HEDIS Documentation Reference Guide Medical Mutual Service Accounts Outpatient Ambulatory Surgery Classification Groups

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Why Work with Us
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About Medical Mutual Menu Arrow

Corporate Profile Our Values Member Rights & Responsibilities Compliance Connection Accreditation & Awards Quality Improvement Program Your Community Is Our Community Diversity, Equity & Inclusion Leadership

Careers Culture Awards Our Subsidiaries Benefits Departments Students and Recent Grads Career FAQs Current Openings

News Newsroom Blog
Community Events for Seniors

Therapy Authorization Forms

Please complete and fax the form to the number specified. Registered users of eviCore Healthcare may complete and submit forms electronically.

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