Forms and Training
Resources
General Resources
Fee Schedule Configuration Grids
Integra Partners’ Proprietary Systems Resources
Training Resources from our Payer Partners
Prior Authorization Services Resources
Forms
Below are the required forms to be used for all Integra patients.
Integra Partners Forms
Preauthorization Forms
- 1199SEIU Preauthorization
- Anthem Preauthorization
- Affinity Auth Request Form
- Fidelis Preauthorization
- Healthcare Partners Preauthorization
- Standard Preauthorization Form- Integra.pdf
- WellCare Preauthorization Medicare + Medicaid
- MetroPlus Preauthorization
- SWH MA Authorization Form
- Neighborhood Authorization Request Form (ARF)
- Emblem Unlisted Procedure Code Form
- VCM Prior Authorization Request Form
- SWH NY Authorization Form
- EmblemHealth eviCore DME PA Form
