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PRIOR AUTHORIZATION REQUEST FORM EOC ID: Phone: 800-728-7947 Fax back to: 866-880-4532 Scott & White Prescription Services manages the pharmacy drug benefit for your patient. Certain requests.

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The healthcare provider is usually responsible for initiating prior authorization by submitting a request form to a patient's insurance provider. As mentioned in the “How does prior authorization work?” section above, this will then often prompt a time-consuming back and forth between the provider and payer.

If you have questions or need approval for out-of-network services, you can call Aetna Better Health of Florida toll free at 1-800-470-3555 (Comprehensive Long Term Care) / 1-800-441-5501 (Medicaid) / 1-844-528-5815 (Florida Healthy Kids). More info is in your member handbook.

A Florida Medicaid prior authorization form is used by medical professionals to request State Medicaid coverage for a non-preferred drug prescription in the State of Florida. A non-preferred drug is one that is not on the State-approved Preferred Drug List (PDL).

The list of services that need a prior authorization can include an admission to the hospital after your emergency condition has improved, power wheelchairs, home health visits, MRI X-rays, hospice care, genetic testing, pain management or some outpatient surgery.

Toll Free: 1-877-658-0305 (For TTY, contact California Relay by dialing 711 and provide the Member Services number: 1-877-658-0305).

What is Authorization in Medical Billing? Authorization in medical billing refers to the process wherein the payer authorizes to cover the prescribed services before the services are rendered. This is also termed as authorization or prior authorization services.

The provider must retain copies of all documentation for five years. Fax completed prior authorization request form to Aetna Better Health of Florida at 855-799-2554 or submit Electronic Prior Authorization through CoverMyMeds® or SureScripts.

Ask for PA by calling us: Medicaid Managed Medical Assistance: 1-800-441-5501 (TTY: 711) Florida Healthy Kids: 1-844-528-5815 (TTY: 711)

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232