Forms
Cox HealthPlans has provided the following forms to assist you in providing care for your patients:
Authorization/Precertification Form - This form is used to request authorization of a medical service or procedure.
Prescription Authorization Form - This form is used to request authorization of a particular prescription medication.
Provider Manual
Provider Manual - The provider manual outlines specific services and procedures that may require prior authorization.
Prescription Information
Preferred Drug List - The preferred drug list provides information for medications most commonly used.
Prescription Full Formulary - The prescription full formulary provides information for most medications.
Specialty Drug List - The specialty drug list provides information regarding medications that apply to the fourth tier pharmacy benefit (if applicable).
Are you a registered Cox HealthPlan Provider?
Register »If you have any questions or concerns, or need additional assistance, please contact the Cox HealthPlans Provider Service Department at:
Phone 417.269.2900 or 800.205.7665 Fax 417.269.2949 E-mail providers@coxhealthplans.com
Mailing Address
Cox HealthPlans
PO Box 5750
Springfield, MO 65801-5750
Or visit us at
Cox HealthPlans
Kelly Plaza
3200 S. National, Building B
Springfield, MO 65807