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HEALTH PARTNERS PLANS PRIOR AUTHORIZATION REQUEST FORMChronic Obstructive Pulmonary Disease (COPD) Agent Phone: 2159914300Fax back to: 8662403712Health Partners Plans manages the pharmacy drug benefit
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How to fill out provider prior-authorization
How to fill out provider prior-authorization
01
Contact the insurance company to verify if prior-authorization is required for the specific service or procedure.
02
Fill out the prior-authorization request form with all necessary information including patient's details, provider's information, diagnosis codes, and procedure codes.
03
Submit the completed form along with any supporting documentation such as medical records, test results, and proposed treatment plan to the insurance company.
04
Follow up with the insurance company to ensure that the prior-authorization request has been approved before scheduling the service or procedure.
Who needs provider prior-authorization?
01
Patients
02
Healthcare providers
03
Medical facilities
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What is provider prior-authorization?
Provider prior-authorization is a process in which healthcare providers must obtain approval from a health insurance company before they can perform certain medical procedures or services.
Who is required to file provider prior-authorization?
Healthcare providers such as doctors, hospitals, and other medical professionals are required to file provider prior-authorization.
How to fill out provider prior-authorization?
Providers must submit a request for prior-authorization to the health insurance company, including all necessary medical documentation and information.
What is the purpose of provider prior-authorization?
The purpose of provider prior-authorization is to ensure that medical procedures or services are necessary and appropriate, helping to control healthcare costs and prevent unnecessary treatments.
What information must be reported on provider prior-authorization?
Providers must report details such as the patient's medical history, the proposed treatment or procedure, the reason for the request, and any supporting medical evidence.
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