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On-line Forms

We have tried to make this a very simple and easy plan for you. To further assist you in meeting the paperwork requirements of this process, we are providing the most commonly used forms on this site, in MSWord format. Please feel free to download these documents.

 

Note: Effective with the 2002-2003 Plan Year, we will no longer accept handwritten re-authorizations.

For your convenience, the "Reauthorization Form" below can be downloaded, completed and faxed (303-384-2009) to us.

Confirmation and Verification Form

Reauthorization Form

Claim Form

Provider Resources