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Procedures Requiring Prior Authorization
All Viva Health and Viva Medicare members require the Primary Care Physician and/or Specialist to
contact the Medical Management Department in advance for
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How to fill out procedures requiring prior authorization
How to fill out procedures requiring prior authorization
01
To fill out procedures requiring prior authorization, follow these steps:
02
Contact your healthcare provider to find out if the procedure requires prior authorization.
03
Obtain the necessary forms or documentation from your healthcare provider or insurance company.
04
Fill out the forms accurately, providing all the requested information.
05
Include any supporting medical records or documentation that may be required.
06
Double-check the completed forms for any errors or missing information.
07
Submit the filled-out forms and any supporting documents to your insurance company.
08
Keep copies of all the submitted forms and documents for your records.
09
Wait for a response from your insurance company regarding the authorization status of the procedure.
10
Follow up with your healthcare provider or insurance company if you have not received a response within a reasonable timeframe.
11
Once you receive authorization, schedule the procedure with your healthcare provider.
Who needs procedures requiring prior authorization?
01
Procedures requiring prior authorization are typically needed by individuals seeking specific medical treatments or services that may have coverage limitations or require additional review by insurance companies.
02
This may include procedures such as certain surgeries, diagnostic tests, specialist consultations, experimental treatments, or high-cost medications.
03
The specific criteria for needing prior authorization can vary depending on the insurance plan and the nature of the procedure.
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What is procedures requiring prior authorization?
Procedures requiring prior authorization are medical services or treatments that must be approved by a health insurance plan before they are performed.
Who is required to file procedures requiring prior authorization?
Healthcare providers are required to file procedures requiring prior authorization on behalf of their patients.
How to fill out procedures requiring prior authorization?
Healthcare providers must submit the necessary documentation and information to the insurance company for review and approval.
What is the purpose of procedures requiring prior authorization?
The purpose of procedures requiring prior authorization is to ensure that the medical services or treatments being requested are medically necessary and appropriate.
What information must be reported on procedures requiring prior authorization?
Information such as medical records, diagnosis, treatment plans, and justification for the requested services must be reported on procedures requiring prior authorization.
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