Quality Care Partners - QCP - Zanesville Ohio

Contact Quality Care Partners Zanesville Ohio

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helpline for assistance - 888-258-7621


Prior Authorization Forms


Authorization Request: CT Scan

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Authorization Request: Epidural Injections

Cervical & Thoracic - Intralaminar and Transformaminal. Lumbar - Intralaminar, Transforaminal and Caudal

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Authorization Request: Facet Injections

Paravertebral Facet Joint or Medial Branch Block

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Authorization Request: MRI / MRA

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Authorization Request: Outpatient Therapies

Physical Occupational Speech Therapies

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Authorization Request: Radiofrequency Ablation

(Medial Branch Neurotomy, Radiofrequency Neurolysis, Facet Ehizotomy)

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Authorization Request: Sacroiliac (SI) Injections

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Authorization Request - Other Subtitle Infrequently Used

Only use when referral does not fall under one of the above forms

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Quick Contact

Quality Care Partners - 33 South 5th Street - Zanesville, OH 43701