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Get Public Facility Use Certification Form - Humana Military
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How to fill out the Public Facility Use Certification Form - Humana Military online
Filling out the Public Facility Use Certification Form - Humana Military online is a straightforward process designed to ensure proper documentation of service availability. This guide provides a clear pathway to complete each section of the form accurately.
Follow the steps to successfully complete the form online.
- Click ‘Get Form’ button to obtain the form and access it in the editor.
- Begin by entering the beneficiary's name at the top of the form. Ensure this is the exact name as per legal documentation.
- In the section labeled 'Availability of service from public agency,' review the types of services listed such as audiology and speech therapy.
- If services are available, describe the extent, frequency, and funding of each service in the specified text area. Be clear and detailed to provide a comprehensive overview.
- Include a phone number for the public official so that any necessary follow-up can be easily conducted.
- Once all fields are filled out, you can save any changes, download the form, print it for physical records, or share it as required.
Complete your Public Facility Use Certification Form online today for smooth processing!
A referral is not required for services. Certain services (e.g., Applied Behavior Analysis (ABA), inpatient admissions, some behavioral health services, adjunctive dental care, home health services, etc.) require prior authorization. You can get care from any TRICARE-authorized provider, network or non-network.
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