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MOLINA HEALTHCARE MEDICAID PRIOR AUTHORIZATION/PRESERVICE REVIEW GUIDE EFFECTIVE: 01/01/2021 REFER TO MOLINA PROVIDER WEBSITE OR PRIOR AUTHORIZATION LOOKUP TOOL/MATRIX FOR SPECIFIC CODES THAT REQUIRE

How to fill out prior authorizationpre-service review guide

How to fill out prior authorizationpre-service review guide

1. Contact the patient’s insurance company to determine if prior authorization is required for the service or procedure.
2. Obtain the necessary forms from the insurance company or download them from their website.
3. Fill out the forms completely and accurately, including all required patient information, physician information, and details about the requested service or procedure.
4. Attach any supporting documentation, such as medical records or test results, to the forms.
5. Submit the completed forms and supporting documentation to the insurance company either online, by fax, or by mail.
6. Follow up with the insurance company to ensure that the prior authorization request has been received and processed.

Who needs prior authorizationpre-service review guide?

1. Patients who are planning to undergo a medical service or procedure that requires prior authorization from their insurance company.
2. Healthcare providers who are submitting requests for services or procedures that require prior authorization.

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What is prior authorizationpre-service review guide?

Prior authorization/pre-service review guide is a process used by insurance companies to determine if they will cover a specific medication or procedure before it is done.

Who is required to file prior authorizationpre-service review guide?

Healthcare providers are required to file a prior authorization/pre-service review guide in order to receive approval from the insurance company for a specific medication or procedure.

How to fill out prior authorizationpre-service review guide?

To fill out a prior authorization/pre-service review guide, healthcare providers need to provide detailed information about the patient, the medical necessity of the medication or procedure, and any supporting documentation.

What is the purpose of prior authorizationpre-service review guide?

The purpose of prior authorization/pre-service review guide is to ensure that patients receive the appropriate and necessary care while also controlling healthcare costs for insurance companies.

What information must be reported on prior authorizationpre-service review guide?

On a prior authorization/pre-service review guide, healthcare providers must report the patient's personal information, medical history, diagnosis, prescribed medication or procedure, and any relevant supporting documentation.