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COCHLEAR IMPLANT SERVICE PRIOR AUTHORIZATION REQUEST FORM Scheduling Line: (714) 6394991Fax: (714) 7443841Thank you for referring your patient to Providence Speech and Hearing Center. To better serve

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How to fill out cochlear implant service prior

01

Contact your audiologist or cochlear implant surgeon to schedule an appointment for a cochlear implant evaluation.

02

Provide your medical history, hearing test results, and insurance information during the evaluation.

03

Complete any necessary pre-surgical tests, such as a CT scan or MRI.

04

Schedule a surgery date and follow any pre-operative instructions provided by your healthcare team.

05

Attend all post-operative appointments to ensure proper programming and rehabilitation of your cochlear implant.

Who needs cochlear implant service prior?

01

Individuals with severe to profound hearing loss who have not benefitted from hearing aids may need cochlear implant service prior.

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What is cochlear implant service prior?

Cochlear implant service prior refers to the process of obtaining authorization from a healthcare payer before proceeding with cochlear implant surgery, ensuring that the procedure is covered under the patient's insurance plan.

Who is required to file cochlear implant service prior?

Typically, it is the responsibility of the healthcare provider or the surgical facility to file a cochlear implant service prior request on behalf of the patient.

How to fill out cochlear implant service prior?

To fill out a cochlear implant service prior, the provider must complete a prior authorization form, including patient details, relevant medical history, treatment plans, and codes for the procedure.

What is the purpose of cochlear implant service prior?

The purpose of cochlear implant service prior is to ensure that the planned procedure is medically necessary and eligible for reimbursement by the patient's insurance plan.

What information must be reported on cochlear implant service prior?

Information that must be reported includes patient demographics, medical history, audiological assessments, treatment plans, and specific coding for the cochlear implant procedure.

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