VA ARTS Service Authorization Review Form - Extension Requests 2022-2025 free printable template

Addiction and Recovery Treatment Services (ARTS) Service Authorization Review Form Extension Requests ADAM Levels 2.1/2.5/3.1/3.3/3.5/3.7/4.0 Last Updated January 10, 2022, No Service Authorization

How to fill out VA ARTS Service Authorization Review Form

How to fill out VA ARTS Service Authorization Review Form

1. Obtain the VA ARTS Service Authorization Review Form from the appropriate VA office or website.
2. Fill in patient information accurately including name, contact details, and social security number.
3. Provide details about the service being requested, including type, duration, and frequency.
4. Include the referring VA staff member's information along with their contact details.
5. Attach any supporting documentation that justifies the need for the requested services.
6. Review the completed form for accuracy and completeness before submission.
7. Submit the form to the designated VA office, either in person or electronically as required.

Who needs VA ARTS Service Authorization Review Form?

1. Veterans seeking authorized services through the VA ARTS program.
2. Service providers who require authorization to deliver specific services to eligible veterans.
3. VA staff members involved in referring veterans to the ARTS program.

People Also Ask about

What is timely filing for Virginia Premier Medicaid?

What is the time limit for appealing the outcome of a claim? Appeals for denied claims must be submitted to Virginia Premier within 60 days from the date on the Virginia Premier remit.

Is Virginia Premier part of Medicaid?

Virginia Premier has been inspiring healthy living in the communities we serve since 1995. Our Medicaid and Medicare Advantage (HMO D-SNP) health plans cover doctor visits, emergency care, hospital stays and prescriptions. When you are a member, you also get no-cost extra benefits.

How to order a new Virginia Premier card?

You can call Member Services at 1-800-727-7536 (TTY: 711). They can take your call any time Monday through Friday, 8:00 am to 8:00 pm.

Does VA Premier require prior authorization?

Referrals are not required when sending a member to a participating specialist. However, authorization is required if a member is sent to a non-participating provider.

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These are the health plans Medicaid and FAMIS members can choose: Aetna Better Health of Virginia. Anthem HealthKeepers Plus. Molina Complete Care of Virginia. OptimaHealth Family Care. UnitedHealthcare Community Plan. Virginia Premier.

Is Virginia Premier the same as Virginia Medicaid?

Virginia Premier Elite Individual is our Medallion Medicaid plan. This plan is for adults ages 19 to 64 and families, including parents, infants, children, teens and pregnant women. It is also for children in foster care or adoption assistance. View plan and added benefits.

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What is VA ARTS Service Authorization Review Form?

The VA ARTS Service Authorization Review Form is a document used by the Department of Veterans Affairs to evaluate and approve requests for services related to rehabilitation and support for veterans.

Who is required to file VA ARTS Service Authorization Review Form?

Veterans seeking rehabilitation services, their healthcare providers, or caregivers who are coordinating services on behalf of the veterans are required to file the VA ARTS Service Authorization Review Form.

How to fill out VA ARTS Service Authorization Review Form?

To fill out the VA ARTS Service Authorization Review Form, provide accurate personal information, specify the service being requested, include relevant medical and treatment history, and sign the form to authorize review and processing.

What is the purpose of VA ARTS Service Authorization Review Form?

The purpose of the VA ARTS Service Authorization Review Form is to ensure that veterans receive appropriate and authorized services, while allowing for a systematic review of service requests to meet clinical needs.

What information must be reported on VA ARTS Service Authorization Review Form?

The information that must be reported on the VA ARTS Service Authorization Review Form includes the veteran's demographic details, description of the requested service, medical history, current treatment plan, and any necessary supporting documentation.