Prior Auth Required

12121 - North Corporate Parkway

This procedure appears on the selected insurer prior authorization source.

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Prior authorizationPrior Auth Required
Procedure / ServiceNorth Corporate Parkway
Procedure / Service Description

Provider Relations and Contracting - Fax: 414-755-4410 DentaQuest of WI Email: providerrelations@trilogycares.com Attn: Claims (or Appeals) 12121 North Corporate Parkway Behavioral Health Mequon, WI 53092 Trilogy Health Insurance Electronic claims: via DentaQuest’s website

Likely documents
  • Confirm benefit details
  • Submit clinical notes if requested by the plan
Next actions
  • Confirm the current plan policy before submission.
  • Use the insurer authorization workflow for this listed code.