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Get Initial Requests For Diagnosis Of Narcolepsy Type 1 (narcolepsy With Cataplexy):

Services to support administration of Healthy Connections. To report fraud, call our confidential Fraud Hotline at 877-725-2702. You may also call the South Carolina Department of Health and Human Services Fraud Hotline at 888-364-3224 or email fraudres scdhhs.gov. WEBPBSC-0244-16 December 2016 SC Medicaid PAB Fax Form 12.16.docx CONTAINS CONFIDENTIAL PATIENT INFORMATION (sodium oxybate) Complete form in its entirety and fax to: Prior Authorization of Benefits (PAB) Center at 1-.

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