Get the free Prior Authorization/Pre-Service Review Guide

Molina Healthcare of Ohio Marketplace Prior Authorization/PreService Review Guide Effective: 01/01/2015 Use Clear Coverage for faster turnaround times. Contact Provider Services for details ***Referrals

How to fill out prior authorizationpre-service review guide

How to fill out prior authorization/pre-service review guide:

1. Begin by gathering all necessary information and documents required for the prior authorization/pre-service review process.
2. Read through the guide carefully to understand the specific requirements and steps involved.
3. Start with the patient's personal information, including their name, date of birth, contact details, and insurance information.
4. Provide detailed information about the healthcare service or procedure that requires prior authorization, such as the CPT or HCPCS code, diagnosis codes, and any supporting medical documentation.
5. Fill out any additional sections of the guide that pertain to the specific service or procedure, such as medication information or any relevant clinical notes.
6. Double-check all the information entered for accuracy and completeness.
7. If required, include any additional supporting documents or notes that may aid in the authorization review process.
8. Once the guide is fully completed, review it once again to ensure all sections have been addressed and nothing is missing.
9. Submit the filled-out prior authorization/pre-service review guide as per the instructions provided by the healthcare payer or organization.
10. Keep a copy of the filled-out guide and any supporting documents for your records.

Who needs prior authorization/pre-service review guide:

1. Healthcare providers: Physicians, surgeons, specialists, or other medical professionals who perform services or procedures that require prior authorization.
2. Patients: Individuals who are planning to undergo healthcare services or procedures that are subject to prior authorization.
3. Insurance companies or payers: Third-party payers who require prior authorization to ensure the medical necessity and appropriateness of certain healthcare services or procedures before providing coverage and payment.

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