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Medical authorization forms are official documents that grant permission for healthcare providers, insurers, and government agencies to access medical information, approve services before they are delivered, or process insurance claims. These forms serve as a critical checkpoint in the healthcare system — ensuring that treatments are medically necessary, covered under a patient's plan, and properly documented before care begins. Common examples include prior authorization requests for specialized services like Applied Behavioral Analysis (ABA) therapy, out-of-network exception requests, and disclosure authorizations like the SSA-827, which allows the Social Security Administration to review medical records when evaluating benefit eligibility.

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SSA-827 · Filled by Instafill.ai in 26 sec

SSA-827 filled by Instafill.ai

About medical authorization forms

These forms are used by a wide range of people: patients seeking coverage approvals, licensed clinicians and behavioral health providers requesting authorization for ongoing treatment, fertility clinic staff collecting intake information, and insurance claimants submitting supporting documentation for critical illness benefits. Situations that commonly require these forms include starting ABA therapy for autism treatment, requesting palliative care services, filing a critical illness insurance claim, or seeking an exception to use an out-of-network specialist. Health plans like Alameda Alliance for Health and insurers like Health Net and Aflac each have their own specific versions, adding complexity for providers managing multiple payers.

Because these forms often involve detailed clinical codes, provider credentials, and member identifiers, even small errors can delay authorization decisions or result in denied coverage. Tools like Instafill.ai use AI to fill these forms accurately in under 30 seconds, making it significantly easier to handle the paperwork without sacrificing precision or data security.

Forms in This Category

Form Name Pages
1. Form SSA-827, Authorization to Disclose Information 2
2. Center for Infertility & Reproductive Surgery – New Patient Questionnaire and Patient/Guarantor Statement (Brigham and Women’s Hospital, Department of Obstetrics and Gynecology) 4
3. The Department of Medical Assistance Services Applied Behavior Analysis Preservice Service Authorization Request Form (Effective Dates of Service 09/01/2025 and after) 8
4. Continental American Insurance Company (CAIC) / Aflac Group Critical Illness Claim Form (with Attending Physician’s Statement, HIPAA Authorization to Obtain Information, and Electronic Funds Transaction Authorization) 8
5. Prior Authorization (PA) Request Form – Adult Palliative Care (Alameda Alliance for Health) 5
6. Alameda Alliance for Health Prior Authorization (PA) Request Form – Adult Palliative Care 5
7. Out-of-Network Pre-Authorization and Exception Request Form 2
8. Out-of-Network Pre-Authorization and Exception Request Form 2
9. ABA Authorization Request (Medi-Cal) – Initial and Concurrent Requests 2
10. Applied Behavioral Analysis (ABA) Prior Authorization Request Form (Health Net Behavioral Health Autism Center) 1
11. Applied Behavioral Analysis (ABA) Prior Authorization Form (New Hampshire) 6
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