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BEHAVIORAL HEALTH SERVICES PRIOR AUTHORIZATION LIST FOR DATES OF SERVICE ON OR AFTER JANUARY 1, 2015, CignaHealthSpring is committed to providing our customers with the highest quality and greatest
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How to fill out for dates of service:

01
Start by locating the section on the form that asks for dates of service. This is usually found in the employment or service history section.
02
Determine the specific dates of the service you wish to provide. This could be a period of employment, a project duration, or a specific event.
03
Write the start date of the service in the designated space on the form. Make sure to include the month, day, and year.
04
Next, write the end date of the service in the designated space on the form. Again, include the month, day, and year.
05
If the service is currently ongoing, indicate this by writing "present" or "ongoing" instead of an end date. This is common for current employment or ongoing projects.
06
Double-check your entries for accuracy and completeness. Ensure that you have accurately written the dates and that they align with your actual service history.

Who needs dates of service:

01
Employers often require dates of service to verify an individual's employment history and to assess their experience and qualifications.
02
Educational institutions may request dates of service to validate a student's enrollment and academic progress.
03
Service providers or contractors may need to document their project durations or periods of service for billing or reference purposes.
04
Government agencies or organizations may ask for dates of service to determine eligibility for benefits or services.
05
Professional organizations or licensing boards may require dates of service as part of their application or renewal processes.
06
Individuals may also need dates of service for personal records or for applications related to loans, insurance, or other areas where employment or service history is relevant.
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Dates of service refer to the specific dates that services were provided or received.
Healthcare providers, insurers, and other relevant parties may be required to file for dates of service.
Dates of service can typically be filled out on claim forms or electronic billing systems.
Dates of service are important for accurately documenting when healthcare services were rendered.
Information such as the type of service provided, the healthcare provider, and the dates of service must be reported.
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