Get Ucare U7834

This guide provides clear and detailed instructions for filling out the UCare U7834, a prior authorization form for mental health services. Whether you are a patient or a service provider, following these steps will ensure that your form is completed accurately and efficiently.

Follow the steps to successfully complete the UCare U7834.

1. Click ‘Get Form’ button to obtain the form and open it in your preferred editor.
2. Fill out the patient information section, including the member name, member ID, address, city, state, zip code, date of birth, phone number, and gender.
3. Complete the service provider information section with details such as ICD-10 code, service provider contact person, name, ID/NPI number, address, city, state, zip code, phone number, fax, and email.
4. Choose between a standard or expedited request. For expedited requests, ensure that the situation justifies immediate attention.
5. Provide details about the service item requested, including service dates, requested codes, and units requested.
6. Indicate who sent the request and their contact number, and state the total number of pages faxed.
7. Select the applicable service type for mental health from the provided options.
8. Attach the required documentation based on the selected service type to support medical necessity. Ensure all necessary documents are included.
9. Review all fields for accuracy and completeness, as incomplete or illegible forms will be returned.
10. Once confirmed, save your changes, download, print, or share the completed UCare U7834 form as needed.

Begin your document submission process online by following the steps outlined above.