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Get Dme/p&o Prior Authorization Form - Priority Health
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How to fill out the DME/P&O Prior Authorization Form - Priority Health online
This guide provides clear instructions for completing the DME/P&O Prior Authorization Form for Priority Health online. By following these steps, users can ensure accurate and efficient submission of their forms.
Follow the steps to complete the form accurately.
- Click ‘Get Form’ button to access the form and open it in the designated editor.
- Fill out the member's information. Provide the last name, first name, Priority Health ID number, and date of birth in the designated fields.
- Complete the 'Requested By' section. Enter the ordering physician's name, phone number, fax number, and address. Include a contact name if applicable.
- Describe the diagnosis in the 'Diagnosis (description)' field. Ensure to include the relevant diagnosis codes in the appropriate section.
- Indicate the requested date span by filling in the 'From' and 'To' fields.
- Choose the appropriate option for 'Purchase' or 'Rental' by filling in the checkbox.
- Fill out the DME provider information, including the provider's name, Tax ID, address, phone, fax, and contact name.
- Provide mandatory documentation for prior authorization, ensuring to attach a complete description and medical necessity for NOC codes, a copy of the physician’s order, and relevant repair costs.
- Enter details regarding the quantity, procedure code, make/model, description, and retail price for each item requested.
- Review all entered information for accuracy. Save changes made to the form, and choose to download, print, or share the completed form as needed.
Complete and submit your documents online to ensure efficient processing.
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Pre-authorizations can take time due to various factors, including the volume of requests Priority Health receives and the complexity of the case. Additionally, incomplete forms can lead to delays as the insurance company may request further information. To help, ensure your DME/P&O Prior Authorization Form - Priority Health is accurate and complete upon submission, reducing unnecessary delays.
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