Get True Health Prior Authorization Form

Filling out the True Health Prior Authorization Form is an essential step in obtaining necessary medical services. This guide provides detailed, step-by-step instructions to help users complete the form accurately and efficiently online.

Follow the steps to successfully complete the True Health Prior Authorization Form online.

1. Press the ‘Get Form’ button to acquire the True Health Prior Authorization Form and open it in your selected editing tool.
2. Begin with the priority and frequency section. Indicate whether the request is standard or urgent/expedited, and specify the date for scheduled services if applicable.
3. Fill out the enrollee information. Include the enrollee's name, date of birth, subscriber/member ID number, and street address along with the city, state, and zip code.
4. Complete the provider information section. Specify whether the ordering or rendering provider is applicable. Include the provider's name, type or specialty, administrative contact information, NPI number, clinic or facility name, and relevant addresses.
5. In the requested medical or behavioral health course of treatment section, describe the service required and indicate the setting by choosing from the options provided.
6. Input necessary codes in the HCPCS/CPT/CDT/ICD-10 codes section, including the latest ICD-10 code and the relevant codes for the requested services.
7. If applicable, complete the frequency/quantity/repetition request section to outline the type of service and the number of units or visits needed.
8. For prescription drug requests, provide the diagnosis name and code, along with required patient information like height and weight. Specify the route of administration and the medication details.
9. In the previous services/therapy section, document any prior treatments including the type, dosage, duration, and reasons for discontinuation.
10. Finally, complete the attestation. Certify the accuracy of the information by providing a signature and date.
11. Once all sections have been filled out, save your changes, and then download, print, or share the completed True Health Prior Authorization Form as needed.

Complete your True Health Prior Authorization Form online today for a seamless submission process.