Advocate Health Care


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Approval for Care Form

Please Note: We strongly recommend you tell your authorized non-network provider that your plan benefits will only cover reasonable and customary charges. You may be billed for any amount above these rates if your provider charges more, so make sure you discuss and agree on charges with your provider before you receive care or treatment. This Approval for Care Form is provided as a service to assist you in your request for services outside of the Advocate Centered Network.