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Prior Authorization Criteria Form 10/08/2014 Prior Authorization Form GHA Biguanides (APA) This fax machine is located in a secure location as required by HIPAA regulations. Complete/review information,
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When filling out when conditions are met, the individual or entity must provide the necessary information and documentation to demonstrate that the conditions have been met.
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The information that must be reported on when conditions are met includes details of the criteria being fulfilled, the date of fulfillment, and any supporting documentation.
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