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MOLINA HEALTHCARE OF OHIO MARKETPLACE PRIOR AUTHORIZATION/PRESERVICE REVIEW GUIDE EFFECTIVE: 01/01/2023 REFER TO MOLINA PROVIDER WEBSITE OR PRIOR AUTHORIZATION LOOKUP TOOL/MATRIX FOR SPECIFIC CODES
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Individuals or organizations who are requesting prior authorization from a marketplace or insurance provider may need attachment0marketplace-prior-authorization-request-formremediated accessible pdf.
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attachment0marketplace-prior-authorization-request-formremediated accessible pdf is a form used to request authorization for marketplace services in a remediated accessible PDF format.
Providers and individuals seeking marketplace services are required to file attachment0marketplace-prior-authorization-request-formremediated accessible pdf.
To fill out attachment0marketplace-prior-authorization-request-formremediated accessible pdf, one must provide all the required information accurately and submit it through the designated platform.
The purpose of attachment0marketplace-prior-authorization-request-formremediated accessible pdf is to request authorization for marketplace services in a format that is accessible for individuals with disabilities.
The information that must be reported on attachment0marketplace-prior-authorization-request-formremediated accessible pdf includes personal details, service requested, justification for authorization, and any supporting documentation.
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