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Ces for MPW recipients. When a MPW patient is referred to you for one of these services, review the requirements for MPW coverage in 2.14 and the coverage criteria for the requested service with the patient's attending physician. If the patient appears appropriate for coverage, complete the Medicaid "Request for Prior Approval" (form 372-118) with the physician's assistance. Blank forms are available from EDS at the number in Appendix B, WHO TO CONTACT. Complete the form as follows: 1. PRIOR AU.

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