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REQUEST FOR SERVICE AUTHORIZATIONS (SA) FORMS IMPLEMENTED
09/01/2018
On September 1, 2018, new Request for Service Authorization (SA) Forms, for FeeforService (FFS) Medicaid
recipients only, NOT MCO
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What is instructions fee-for-service authorization forms?
Instructions fee-for-service authorization forms are documents used to obtain approval for a fee-for-service healthcare service or procedure.
Who is required to file instructions fee-for-service authorization forms?
Healthcare providers or facilities that offer fee-for-service healthcare services are required to file instructions fee-for-service authorization forms.
How to fill out instructions fee-for-service authorization forms?
Instructions fee-for-service authorization forms can be filled out by providing the necessary patient and service information, along with any supporting documentation.
What is the purpose of instructions fee-for-service authorization forms?
The purpose of instructions fee-for-service authorization forms is to ensure that healthcare services are approved and authorized before being provided to patients.
What information must be reported on instructions fee-for-service authorization forms?
Information such as patient demographics, medical history, requested services, and provider details must be reported on instructions fee-for-service authorization forms.
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