Get the forms and resources you need for things like Prior Authorization, Practice Update, and more. You can easily find and download what you need to make sure your account stays up to date. All forms may be submitted through the Provider Portal. If you have not yet registered for Provider Portal Access, please click HERE.
HM Fax Precertification Request
Provider Demographic Sheet
Completed forms can be emailed to hmfax@crescenths.com or faxed to 828-670-9159. While Prior Authorizations Forms are available, please keep in mind that you can also submit prior authorization information directly through the Provider Portal. If you have not yet registered for Provider Portal Access, please click HERE. Approval or denial will be provided in a timely basis in all cases.
*Receipt of the Precert/PA form guides our nurses’ ability to assist you. Please do not call nurses prior to submitting this form, and note that nurses are working off-site most days. Approval or denial will be provided timely in all cases.
NOTE: Always refer to member’s insurance card to confirm Crescent Health Solutions provides precertification for the plan.
Completed forms may be submitted through the Provider Portal or can be emailed to hmfax@crescenths.com or faxed to 828-670-9159.
With submission of form, please provide a written explanation of practice change.
DO NOT email forms containing PHI from our website to protect your and our members’ privacy.
Need assistance? Call 828-670-9145 or email credentialing@crescenths.com for additional help.