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CLEAR FORTH DEPARTMENT OF MEDICAL ASSISTANCE SERVICESCommunity Stabilization (S9482)CONTINUED STAY Service Authorization Request Form MEMBER INFORMATION Member First Name:PROVIDER INFORMATION Organization
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01
To fill out the joinmolinahealthcarecom-mediacontinued stay service authorization form, follow these steps:
02
Visit the website joinmolinahealthcare.com.
03
Log in to your account or create a new account if you don't have one.
04
Navigate to the 'Media/Continued Stay Service Authorization' section.
05
Click on the 'Fill out authorization form' button.
06
Provide the required information such as patient details, healthcare provider information, and authorization details.
07
Review the form for any errors or missing information.
08
Submit the form online or print it out and send it via mail or fax, as instructed.
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Keep a copy of the filled-out form for your records.

Who needs joinmolinahealthcarecom-mediacontinued stay service authorization?

01
Joinmolinahealthcarecom-mediacontinued stay service authorization is needed by individuals who require continued stay services under the Molina Healthcare plan.
02
These services may include extended hospital stays, rehabilitation programs, or ongoing medical treatment.
03
Patients or their authorized representatives must obtain the authorization form to grant permission for these services to be covered by Molina Healthcare.
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It is a form used to request authorization for continued stay in a healthcare facility.
Healthcare providers and facilities are required to file the authorization.
The form must be completed with the patient's information, medical history, and reason for continued stay.
The purpose is to ensure that the patient receives the necessary care and treatment during their continued stay.
Patient information, medical history, current condition, treatment plan, and reason for continued stay.
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