Get Shp 2013218

Filling out the Shp 2013218 form for prior authorization can be straightforward when approached step-by-step. This guide will help you navigate through each section of the form to ensure a complete and accurate submission.

Follow the steps to complete the form successfully.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin with the member information section. Fill out the Member ID, last name, first name, and date of birth accurately. These details are critical for processing your request.
3. In the next section, provide the information for the provider who will perform the service. This includes the provider’s NPI, tax ID, fax number, and contact number. Ensure that these details are correct to avoid delays.
4. Indicate if the submitting, referring, or performing provider is the same as the previous entry by checking the box. If not, fill in the respective fields with the new provider's information.
5. Move to the requested service area. Select the type of service by checking the appropriate boxes, such as DME rental, home health, therapy, or other services as applicable.
6. Fill out the clinical review section. Input any procedure codes and service descriptions required. Specify the start and end dates for the service, along with the referring diagnosis code.
7. If applicable, check the box indicating that this is an urgent request and include the signature of the requesting physician in the designated area.
8. Review all entered information for accuracy. Once everything is confirmed, you can save your changes, download the form, print it, or share it as necessary.

Complete your authorization requests online for a faster and more efficient process.