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Clinical Information Fax: (505) 213-0246, 1-888-923-5990 Inpatient Fax: (505) 213-0181 Routine Urgent or Expedited Initial Determination For a Prior Authorization/Benefit Certification request to be considered Urgent or Expedited, check all that apply. Please note: Requests that do not meet this criteria may be processed as routine requests. The life or health of a covered person would be jeopardized The covered person s ability to regain maximum function would be jeopardized The m.

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