Prior Authorization Form Behavioral Health Services - CDPHP
https://www.cdphp.com/-/media/files/providers/behavioral-health/forms/behavioral-health-services-prior-authorization-form.pdf
WEBPrior Authorization Form Behavioral Health Services . Mail to: Behavioral Health Services, c/o CDPHP, 500 Patroon Creek Blvd., Albany, NY 12206-1057, fax to (518) 641-3601, or submit online by logging into www.cdphp.com. . All fields must be completed and legible or the request cannot be processed.
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