Digital Upload for Supporting Documentation


PDF Version

TO:   All Providers

RE:   Digital Upload for Supporting Documentation


The Provider Secure Web Portal allows users to digitally upload additional supporting documentation for the following form types after initial form submission: Consent, Third Party Liability Claims, Prior Authorization (Non-Pharmacy PA), and Prior Authorization Reconsideration (Non-Pharmacy PA).


After initial submission of one of the above form types, users may submit additional supporting documentation using the Digital Upload form and may be accessed at the following location within the portal:


Trade Files / Forms / DIG-Digital Upload


To complete the form, the following information is required:

  • Record ID (from original form submission)
  • Form Type
  • PA, ICN, or CA Number (depending on which form type is used)

Attachments being submitted must be in PDF format.


Once submitted, the supporting documentation will be added to the original form submission.


Note: Providers with questions concerning the upload of supporting documentation should contact their Provider Representative. Contact information may be found at the following link:



The Current Procedural Terminology (CPT) and Current Dental Terminology (CDT) codes descriptors, and other data are copyright © 2021 American Medical Association and © 2021 American Dental Association (or such other date publication of CPT and CDT). All rights reserved. Applicable FARS/DFARS apply.