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MOLINA HEALTHCARE MARKETPLACE PRIOR AUTHORIZATION/PRESERVICE REVIEW GUIDE EFFECTIVE: 01/01/2021 REFER TO MOLINA PROVIDER WEBSITE OR PORTAL FOR SPECIFIC CODES THAT REQUIRE AUTHORIZATION ONLY COVERED
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How to fill out only covered services are

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Start by understanding your insurance coverage and what services are considered as 'covered'. This information can usually be found in your insurance policy or by contacting your insurance provider.
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Make a list of the specific services that are covered under your insurance plan. This may include medical procedures, prescription medications, mental health services, or other specific treatments.
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When seeking medical or healthcare services, ensure that you choose providers or facilities that are in-network and accept your insurance. This will help ensure that you won't be billed for any services that are not covered.
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Before receiving any medical services, it's important to verify with the provider that the specific service is covered under your insurance plan.
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Only covered services are services that are included in a specific insurance policy or plan.
The policyholder or the individual receiving the services may be required to file the only covered services are.
To fill out the only covered services are, you need to accurately report the services that are covered under your insurance policy.
The purpose of only covered services are is to document the services that are eligible for coverage under an insurance policy.
You must report the specific services that are covered, the dates of service, and any applicable copayments or deductibles.
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