Fillable dmas 260 form

Description
Residential Treatment Care(Level C) Prior Authorization Request Fax Form "KePRO/DMAS now require any Medicaid Provider submitting Prior Authorizations using their National Provider Identifier (NPI) or Atypical Provider Identifier (API) to provide their 9 digit zip code. If you do not know your 9 digit zip code then please visit: http://zip4.usps.com/zip4/welcome.jsp" Initial Review Continued Stay Review Retro...
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dmas 260 form