Sunshine prior authorization form 2026

1. Click ‘Get Form’ to open the sunshine prior authorization form in the editor.
2. Begin by entering the member information. Fill in the required fields such as Date of Birth, Member ID/Medicaid ID, and Last Name, First. Ensure all mandatory fields are completed to avoid rejection.
3. Next, provide the requesting provider information. Input the Requesting NPI, TIN, Provider Contact Name, and phone/fax details. This section is crucial for processing your request efficiently.
4. For servicing provider information, if it’s the same as the requesting provider, check the corresponding box. Otherwise, fill in Servicing NPI, TIN, and contact details.
5. In the authorization request section, enter Primary Procedure Code, Start/Admission Date, Diagnosis Code, and any additional procedure codes. Make sure to include total units/visits/days as required.
6. Select the outpatient service type by filling in the square with an X next to your chosen option. Review all entries for accuracy before submission.

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