This is a legal form that was released by the Nevada Department of Health and Human Services - a government authority operating within Nevada. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is Form FA-61?
A: Form FA-61 is a Prior Authorization Request form.
Q: What is Actemra (Tocilizumab)?
A: Actemra (Tocilizumab) is a medication used to treat certain types of arthritis.
Q: What is the purpose of Form FA-61?
A: The purpose of Form FA-61 is to request prior authorization for Actemra (Tocilizumab) in Nevada.
Q: Why is prior authorization required for Actemra (Tocilizumab)?
A: Prior authorization is required to ensure appropriate use of Actemra (Tocilizumab) and to determine coverage eligibility.
Q: What information is needed to complete Form FA-61?
A: You will need to provide your personal information, healthcare provider information, and relevant medical documentation.
Q: How long does the prior authorization process take?
A: The length of the prior authorization process can vary, but it is typically completed within a few business days.
Q: What happens after submitting Form FA-61?
A: After submitting Form FA-61, it will be reviewed by the Medicaid program to determine if prior authorization for Actemra (Tocilizumab) will be approved.
Form Details:
Download a fillable version of Form FA-61 by clicking the link below or browse more documents and templates provided by the Nevada Department of Health and Human Services.