Provider Forms

• Forms

To make it easy for you to work with BlueLinkTPA, you'll find a variety of forms here.

• Guide for completing the CMS-1450 (institutional claims) form (PDF)
• Guide for completing the CMS-1500 (professional claims) form (PDF)
• Minnesota Uniform Form for Prescription Drug Prior Authorization (PA) Requests and Formulary Exceptions (PDF)
• Pharmacy quantity limit form (PDF)
• Provider inquiry (PDF)
• Step therapy authorization (PDF)

Prior authorization and preadmission forms

Please see the back of the member's ID card to select the appropriate forms:

• Preadmission phone number is 1-866-938-9741
• All others