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VNS Health fax number

(212) 897-9448

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MLTC Authorization Operations

Used for: MLTC service requests and pre-authorization, including DME/supply orders and related documentation (e.g., prescriptions); written communications via fax.

Fax destination details

Department
MLTC Authorization Operations
Purpose
MLTC service requests and pre-authorization, including DME/supply orders and related documentation (e.g., prescriptions); written communications via fax.
Form
Pre-Authorization/Authorization Request Form — Pre-Authorization Request Form
Voice phone
(888) 867-6555

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 facility admissions or service requests with patient details and required information; fax the form to 212-897-9448.

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

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