Utilization Management Forms for Physicians and Enrollees

Looking for forms? L.A. Care offers many forms online for your use and reference, including: 

Provider Prior Authorization Tool
Prior Authorization Request Form/Exception Request Form
Difficult Placement Authorization Request Form
Higher Level of Care (HLOC) Authorization Form
Hospital Priority & Type of Clinical Service Requested Fax Form
Provider Authorization and Billing Reference Guide
L.A. Care Clinical Criteria Hierarchy
Emergency Department Protocols
BHT Authorization Form

To access these forms, please go to our L.A. Care Forms and Manuals web page.

Go to Utilization Management Forms