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Learn more about how Alliance is using technology to make prior authorizations more efficient per the CMS-0057-F rule.

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Online Forms

Quick links to fillable forms.

In an effort to reduce paperwork and make it easier for partners to submit required information, we are working to make certain required forms fillable online. Quicklinks will be added here as those forms become available.

  1. Trading Partner Agreement and Connectivity Form
  2. CFAC Membership Application Form
  3. Request to Add a Behavioral Health Clinician Form (Removed)
  4. Alliance Health Vendor Setup Packet
  5. Alliance Electronic Funds Transfer (EFT) Authorization Agreement and Change Form
    (Removed. Email [email protected])