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FAX Completed Form To (866) 9407328 Request for Prior Authorization ERYTHROPOIETIN STIMULATING AGENTS Prior Authorization Phone (800) 3106826 (PLEASE PRINT ACCURACY IS IMPORTANT) IA Medicaid Member
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Once you are confident that the form is complete, prepare it for faxing. This may involve placing the form with any attachments in a cover sheet or envelope to protect it during transmission.
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Dial the fax number of the intended recipient and wait for the fax machine to establish a connection. Follow any specific instructions provided by the recipient, such as dialing any access codes or waiting for a confirmation page.
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What is fax completed form to?
The completed form should be faxed to the designated fax number provided by the recipient.
Who is required to file fax completed form to?
The individual or entity required to file the form should fax it to the designated fax number.
How to fill out fax completed form to?
The form should be completed with accurate information and then faxed to the designated fax number.
What is the purpose of fax completed form to?
The purpose of faxing the completed form is to provide the recipient with the necessary information.
What information must be reported on fax completed form to?
The form should include all required information specified by the recipient.
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