Get Advantek Prior Authorization

Navigating the Advantek Prior Authorization process can seem daunting, but with the right guidance, it becomes manageable. This guide provides a clear, step-by-step approach to help you fill out the form correctly and efficiently.

Follow the steps to complete the Advantek Prior Authorization form online.

1. Press the ‘Get Form’ button to obtain the Advantek Prior Authorization form and open it for editing.
2. Begin by entering the patient information. This includes the patient’s name, date of birth, and identification number. Specify if the patient has other insurance, including the name of the other carrier if applicable.
3. Indicate the patient's gender and any relevant information regarding accidents, such as motor vehicle accidents, job-related injuries, or pregnancy-related issues.
4. In the 'Requesting Service Information' section, fill in details for the requesting physician, including their name, signature, and contact information. Also, indicate the provider or facility requested for service.
5. Complete the details regarding the requested service including the admitting physician/surgeon, tentative date of service, and the requested number of days or visits.
6. If applicable, specify if an assistant surgeon is requested and provide their name.
7. Provide the diagnosis codes (ICD-9) and requested procedure codes (CPT) for the services to be performed.
8. Include any additional comments or specific details in the comments section provided at the bottom of the form.
9. After carefully reviewing the filled-out form for accuracy, save your changes. You can then proceed to download, print, or share the completed document as necessary.

Complete your Advantek Prior Authorization form online today to ensure timely processing.