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CONTAINS CONFIDENTIAL PATIENT INFORMATION Calls () Prior Authorization of Benefits (PAB) Form Complete form in its entirety and fax to: Prior Authorization of Benefits Center at (800) 601 4829 1.
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Patient has a diagnosis refers to the medical condition or illness that the patient has been diagnosed with.
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The information that must be reported on patient has a diagnosis includes the specific medical condition or illness, the date of diagnosis, any relevant diagnostic tests or procedures conducted, and any other pertinent details.
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