Please Note: Authorization request must - Home - myNEXUS 2026

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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by entering the 'Date of Request' at the top of the form. Specify whether this is a Standard, Retro, or Urgent Request.
  3. Fill in the 'Member Name', 'DOB', and 'Member ID#' in the required fields. Ensure accuracy as these details are crucial for processing.
  4. Complete the 'Requestor Name' and 'Requestor Email' sections. This information helps in communication regarding your request.
  5. Indicate if there is an authorization number and provide details about the caregiver's ability to assist.
  6. In the Agency Request section, fill out the certification period dates and specify the discipline along with visit requests.
  7. Ensure you check off all items on the REQUIRED CHECKLIST before submitting your form for review.

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