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Home Infusion Prior Authorization Form Page 1 of 1 New Request ReCertification Request Auth # Change Place of Service Please return completed form to the Utilization Management Department at (401)4596023. Please

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What is re-certification request -auth?

Re-certification request -auth is a process of verifying and updating authorization credentials.

Who is required to file re-certification request -auth?

Individuals or organizations with authorization credentials that need to be renewed are required to file re-certification request -auth.

How to fill out re-certification request -auth?

To fill out re-certification request -auth, one needs to provide updated information and documentation related to their authorization credentials.

What is the purpose of re-certification request -auth?

The purpose of re-certification request -auth is to ensure that individuals or organizations continue to meet the requirements for maintaining their authorization credentials.

What information must be reported on re-certification request -auth?

On re-certification request -auth, one must report any changes in information or documentation related to their authorization credentials.

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