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Web start the application builder: Web to become an authorized representative, you'll need to download and print the appointment of representative form. Download, print, and complete the. Remember, the following information is for the person or organization appointed as power of attorney for a humana member. Web preauthorization and referral request information for healthcare providers..
Humana Aor Form Web agent of record change form • this form is to be completed when an employer/group is requesting an agent change. To easily access and download applications and enrollment forms, you will be asked to provide some basic information on the following screens. Remember, the following information is for the person or organization appointed as power of attorney for a humana member. Download, print, and complete an aor form, which you can. Please complete all fields on this form and be sure to include an area code along with your telephone and fax numbers.
And Its Subsidiaries Comply With Applicable Federal Civil Rights Laws And Do Not Discriminate On The Basis Of Race, Color, National Origin, Age, Disability, Or Sex.
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