Precertification completed by HPI AchieveHealth® CMS
Precertification forms below are only for plans using AchieveHealth CMS in New England and Halifax. Please verify the correct precertification vendor prior to submitting forms; unverified precertifications will be returned.
AchieveHealth Precertification List
- Complete a Precertification Request Online
- Need to fax your form?
Download a Precertification Request form* (unverified requests may not be processed)
*If your patient's plan requires Precertification for a service or procedure listed below, please complete the Standard Precertification Request form in addition to the applicable form below.