Referral Form

All Lines of Business:

* McLaren Medicaid

* McLaren Healthy Michigan

* McLaren Community

* McLaren Medicare Advantage

* McLaren Health Advantage              

The online electronic Provider Pre-Authorization Request Form is temporarily unavailable.

Please fax your Pre-Authorization Requests along with any supporting documentation to: 
810-733-9647 for those Providers with eFax capabilities or
810-733-9645 for those Providers with analog fax machines