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MagnaCare fax number

(888) 915-9408

Utilization Management

Used for: Appeal requests for prior authorization/coverage decisions

Fax destination details

Department
Utilization Management
Purpose
Appeal requests for prior authorization/coverage decisions
Form
Provider Prior Authorization Request Form — Provider Prior Authorization Request Form
Address
1600 Stewart Avenue, Suite 700, Westbury, NY 11590
Voice phone
800-352-6465

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Attach clinical notes with history and prior treatment; complete member and ordering/provider information; indicate service dates and CPT/HCPCS codes.

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