Requests for Urgent or Expedited Pre-authorization
For urgent or expedited pre-authorization of services, please use the
Pre-authorization Request Form-Clinically Urgent or Expedited
, found at QualChoice.com.
When using this form to request pre-authorization, the patient must be in an urgent condition.
This is a clinical condition that, in the opinion of a physician with knowledge of the member's medical condition, requires prompt medical care.
The requesting Provider must attest to the urgency of the member's condition.