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DEPARTMENT OF HEALTH SERVICES Division of Health Care Access and Accountability F11018 (10/08)STATE OF WISCONSIN HFS 106.03(4), Wis. Admin. Code HFS 152.06(3)(h), 153.06(3)(g), 154.06(3)(g), Wis.
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01
Contact the insurance company or third party payer to inquire about the specific process for making changes to prior authorization.
02
Obtain the necessary forms or documents required to request changes.
03
Fill out the forms with the updated information or changes needed for the prior authorization.
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Provide any supporting documentation or medical records that may be required to support the changes.
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Submit the completed forms and documentation to the appropriate department or individual for review and processing.

Who needs changes to prior authorization?

01
Patients who have undergone a change in their medical condition or treatment plan that requires adjustments to their prior authorization.
02
Healthcare providers who need to update information or make changes to a prior authorization on behalf of their patients.
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Changes to prior authorization refer to modifications in the requirements or processes that must be followed to obtain approval for specific healthcare services or medications before they are provided.
Healthcare providers, insurers, and organizations involved in administering healthcare services are typically required to file changes to prior authorization.
To fill out changes to prior authorization, individuals should complete the designated forms provided by the relevant authority, ensuring all required information is accurately entered and supporting documents are attached.
The purpose of changes to prior authorization is to ensure that healthcare services and treatments are medically necessary and covered under a patient's insurance plan, thereby managing costs and improving patient outcomes.
Information that must be reported typically includes patient identification, service codes, details of the proposed treatment, medical necessity justification, and any prior approval numbers.
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