Get Geha Therapy Fax Request Form

Completing the Geha Therapy Fax Request Form is an essential step for obtaining prior authorization for therapy services for GEHA members. This guide will provide thorough instructions to ensure you fill out the form accurately and efficiently.

Follow the steps to effectively complete the form

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Start by filling in the fax date and the number of pages you are sending. Ensure that you have all the necessary pages ready to be faxed.
3. In the therapy provider information section, enter the facility name, street address, city, state, telephone number, return fax number, GEHA provider ID number, and the National Provider Identifier (NPI) if applicable.
4. Proceed to the request information section where you need to fill out the facility tax ID number and the individual tax ID number, if available.
5. Next, in the patient information section, provide the first name, last name, date of birth, and GEHA member ID number of the patient. Also, indicate the initial evaluation date.
6. For the request type, select whether this request is for the onset of therapy services, extension of therapy services, or other procedures, and indicate if it is for post-operative therapy visits.
7. Select the service type required, whether it be physical therapy, occupational therapy, or speech therapy.
8. Finally, review the entire form for accuracy, ensuring that all fields are completed as instructed. You may then save changes, download a copy, print it out, or share the form as necessary.

Complete your Geha Therapy Fax Request Form online today for seamless authorization processes.