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PRIOR AUTHORIZATION FORM
FORWARD REFERRALS FROM CONTRACTED MD TO CONTRACTED MD (PRIOR AUTHORIZATION NOT NEEDED)
P SW contra a c t ed p r of i d er r e fer i NG to a no the r P S W contracted pro vid
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02
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03
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04
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05
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06
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What is psw referral prior auth?
PSW referral prior auth is the process of obtaining authorization from a payer before services are rendered by a personal support worker.
Who is required to file psw referral prior auth?
The healthcare provider or facility hiring the personal support worker is required to file the referral prior auth.
How to fill out psw referral prior auth?
To fill out a PSW referral prior auth, the healthcare provider needs to provide information about the patient, the services required, and justification for the services.
What is the purpose of psw referral prior auth?
The purpose of PSW referral prior auth is to ensure that the services provided by the personal support worker are medically necessary and covered by the payer.
What information must be reported on psw referral prior auth?
The information that must be reported on PSW referral prior auth includes patient demographics, diagnosis, treatment plan, and expected duration and frequency of services.
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