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REQUEST FOR MEDICARE PRESCRIPTION DRUG COVERAGE DETERMINATION This form may be sent to us by mail or fax: Address: Impact Attention: Coverage Determination 10181 Scripts Gateway Ct. San Diego, CA

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What is attention coverage determination?

Attention coverage determination is the process of determining who is responsible for managing and covering attention services for a particular individual.

Who is required to file attention coverage determination?

The individual's healthcare provider or insurance company is usually required to file attention coverage determination.

How to fill out attention coverage determination?

To fill out attention coverage determination, the healthcare provider or insurance company must provide information about the individual's medical history, treatment plan, and coverage details.

What is the purpose of attention coverage determination?

The purpose of attention coverage determination is to ensure that individuals receive the appropriate attention services and that the costs are covered by the responsible party.

What information must be reported on attention coverage determination?

Information such as the individual's medical condition, recommended treatment plan, and insurance coverage details must be reported on attention coverage determination.

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