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CLEAR FORTH DEPARTMENT OF MEDICAL ASSISTANCE SERVICES MENTAL HEALTH INTENSIVE OUTPATIENT (MH IOP: S9480) and MENTAL HEALTH PARTIAL HOSPITALIZATION PROGRAM (MH IOP: H0035)INITIAL Service Authorization
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To fill out mh-iop-phph0035 or s9480-initial auth, follow these steps:
02
Start by providing the required demographic information, such as patient name, address, date of birth, etc.
03
Next, include the details of the referring physician or healthcare provider, including their name, NPI number, and contact information.
04
Provide information about the insurance plan, such as the name of the insurance company, policy number, and any applicable pre-authorization or referral numbers.
05
Specify the services or treatments being requested, including the procedure codes, diagnosis codes, and any supporting medical documentation.
06
Include any additional information or medical history that may be relevant to the request.
07
Review the completed form for accuracy and completeness before submitting it for authorization.
08
Keep a copy of the filled-out form and any accompanying documents for your records.

Who needs mh-iop-phph0035 or s9480-initial auth?

01
mh-iop-phph0035 or s9480-initial auth is required by individuals who are seeking authorization for a Mental Health Intensive Outpatient Program (MH-IOP) or specific mental health services (code S9480) from their insurance provider.
02
These individuals typically include patients who require more intensive mental health treatment than traditional outpatient care but do not require inpatient hospitalization.
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mh-iop-phph0035 or s9480-initial auth is a form used for initial authorization in mental health outpatient programs.
Mental health professionals or facilities providing outpatient services are required to file mh-iop-phph0035 or s9480-initial auth.
mh-iop-phph0035 or s9480-initial auth must be completed with all relevant patient information and treatment details.
The purpose of mh-iop-phph0035 or s9480-initial auth is to obtain authorization for mental health outpatient services.
Information such as patient demographics, diagnosis, treatment plan, and provider details must be reported on mh-iop-phph0035 or s9480-initial auth.
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