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Neighborhood Health Partnership
Advance Notification/Prior Authorization Requirements
Effective October 1, 2017,
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What is advance notification/prior authorization requirements?
Advance notification/prior authorization requirements are the process of obtaining approval from a payer before a healthcare service is provided, in order to ensure payment.
Who is required to file advance notification/prior authorization requirements?
Healthcare providers or facilities are required to file advance notification/prior authorization requirements.
How to fill out advance notification/prior authorization requirements?
Advance notification/prior authorization requirements can be filled out by submitting the necessary information and documentation to the payer for review and approval.
What is the purpose of advance notification/prior authorization requirements?
The purpose of advance notification/prior authorization requirements is to control costs, ensure medical necessity, and prevent unnecessary procedures.
What information must be reported on advance notification/prior authorization requirements?
Typically, advance notification/prior authorization requirements include patient information, provider information, procedure codes, and clinical documentation.
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