Below are the most commonly used Provider forms and other related resources. If the form you need is not listed, please contact us.
Prior Authorization Form
This form is used to release your protected health information as required by federal and state privacy laws. Your authorization allows
the Health Plan to release your protected health information to a person or organization that you choose.
Transition of Care coverage allows you to continue to receive
services for specified medical and behavioral conditions for a defined period of time with health
care professionals who do not participate in the FirstCare Health Plans network until the safe
transfer of care to a participating doctor or facility can be arranged.