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Fidelis Care is pleased to announce that we have 3 new inpatient prior authorization fax forms available on this site. Be sure to fill out the forms completely with all relevant information to help us expedite the processing of your requests. The new forms below can be found on this site located under Provider Resources, click Manuals and Forms, click the Forms and Applications drop-down arrow, then scroll down to Treatment/Service Request Forms, or simply click the hyperlinks below: • Inpatient Emergency Room Request Form • Inpatient Rehabilitation Request Form • Concurrent Inpatient Rehabilitation Therapy Progress Review Request Form
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