Healthscope Benefits Provider Prior Authorization Form

If you are joining a current provider group or participating clinic with healthSCOPE Benefits, please select the Contact Provider Relations tab below and complete the requested information. Once the credentials are provided, you will be notified and transferred by the participating clinic under the current agreement. If you are not joining a supplier group or participating clinic, please select the Supplier Relations Contact tab below and fill in the requested information. Your data will be verified by our contract staff and if it meets the current needs of our suppliers (location, area of expertise, etc.), a supplier request will be sent to you. Application Status / View Eligible Benefits We support 270/270 transactions via Transunion & Passport. Please use the paying card on the member`s ID card to obtain eligibility….