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01/18/2016 Prior Authorization MERCY MARICOPA INTEGRATED CARE - TXIX/XXI SMI MEDICAID AZ88 This fax machine is located in a secure location as required by HIPAA regulations. Complete/review information sign and date. Fax signed forms to Mercy Maricopa Integrated Care - TXIX/XXI SMI at 1-855-247-3677. Please contact Mercy Maricopa Integrated Care - TXIX/XXI SMI at 1-800-564-5465 with questions regarding the Prior Authorization process. 2. Has the patient failed a 2 month trial of a formulary...
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Who needs juvenile fibromyalgia?
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Juvenile fibromyalgia is a condition that primarily affects children and adolescents.
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It is important to consult with a healthcare professional to determine if a child or adolescent needs to be evaluated for juvenile fibromyalgia.
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What is juvenile fibromyalgia?
Juvenile fibromyalgia is a common chronic pain condition that affects adolescents.
Who is required to file juvenile fibromyalgia?
Healthcare providers or parents are required to file juvenile fibromyalgia.
How to fill out juvenile fibromyalgia?
Juvenile fibromyalgia can be filled out by providing information about the patient's symptoms, medical history, and any relevant test results.
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The purpose of juvenile fibromyalgia is to document and monitor the condition of adolescents with chronic pain.
What information must be reported on juvenile fibromyalgia?
Information such as the patient's symptoms, medical history, and any relevant test results must be reported on juvenile fibromyalgia.
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