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Network Health fax number
(920) 720-1916
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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
- Website
- Visit organization website
Before you send
- Confirm that this exact department handles your document or request.
- Check the organization website or call its main line for the current fax number.
- Include a cover sheet and any case, member, claim, or form reference required.
- Keep the delivery confirmation with your submission records.
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.
Sources and verification
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