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The Preauthorization Process, Referrals and Recertification. Guidelines. HealthMaintenance Organizations, commonly referred to as HMO's, operate under the concept of managed care. The fundamental
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What is direct authorization referrals?
Direct authorization referrals allow a healthcare provider to refer a patient for a service without prior approval from the insurance company.
Who is required to file direct authorization referrals?
Healthcare providers are required to file direct authorization referrals when referring a patient for a service that requires approval from the insurance company.
How to fill out direct authorization referrals?
Direct authorization referrals can be filled out by providing the necessary patient and provider information, as well as details about the service being referred for.
What is the purpose of direct authorization referrals?
The purpose of direct authorization referrals is to ensure that the patient receives the necessary approval for a service from the insurance company before receiving the service.
What information must be reported on direct authorization referrals?
Direct authorization referrals must include patient information, provider information, service details, and the reason for the referral.
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