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WebApr 6, 2024 · Behavioral Health (Outpatient - ABA) Service Authorization Request. Designation of Authorized Representative Form. Home Health Precertification Worksheet. Inpatient and Outpatient Authorization Request Form. Pharmacy Prior Authoriziation Forms. Last updated on 4/6/2024 11:55:30 AM. WebMedical Specialty Drug Authorization Request Form . Please print, type or write legibly in blue or black ink. Once completed, please fax this form to the designated fax number for … WebHighmark Blue Shield serves the 21 counties of central Pennsylvania and also provides services in conjunction with a separate health plan in southeastern Pennsylvania. … grade 12 geography research project 2022