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DME Ancillary Services Authorization Request FAX TO (855)657-8641 For Florida Medicaid and Florida Medicare FAX TO (877) 338-3713 For Kentucky Medicaid FAX TO (877) 722-3029 For AK, MS, SC, and TN
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2014 Florida Kentucky WellCare DME Requester NPI O2 FRM NA027152 HCPC ICD-10 AKMSSC Authorizations TN exclusions CPT Ancillary eligibility manifesting POS providers ENG entirety Saturation severity customized notification servicing Medicare Billed Medicai

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