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Forms and resources for providers

PEBTF referral

Behavioral health


Home health

  • As of Jan. 16, 2023, you can submit prior authorization requests for home health through Cohere Health. Cohere’s online portal is an easy way to get authorization requests reviewed and approved quickly so your patients can get the care they need. Register with Cohere today!

  • Home Health Services Request Form


Medical Benefit Outpatient Drug

Outpatient rehabilitation


Additional forms and resources

View pharmacy forms

Related information

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