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Network Health fax number

(920) 720-1916

Utilization Management (Population Health)

Used for: Population Health Authorization Request / Prior Authorization

Fax destination details

Department
Utilization Management (Population Health)
Purpose
Population Health Authorization Request / Prior Authorization
Form
authorization — Population Health Authorization Request Form
Address
Network Health, Attn: Utilization Management Department, 1570 Midway Pl., Menasha, WI 54952
Voice phone
920-720-1602

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  • Check the organization website or call its main line for the current fax number.
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Submit the completed Population Health Authorization Request Form to Network Health for processing. Include patient information, service details, and any related medical records supporting medical necessity. Submissions can be faxed to 920-720-1916, emailed via the secure channel provided, or mailed to Network Health, Attn: Utilization Management Department, 1570 Midway Pl., Menasha, WI 54952. You may also submit online via the iExchange provider portal.

Official form instructions are published as a downloadable file on the organization's website.

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