Instructions for Form FA-1B Mobility Assessment and Prior Authorization (Pa) Request - Nevada

Form FA-1B Mobility Assessment and Prior Authorization (Pa) Request - Nevada

This document contains official instructions for Form FA-1B , Mobility Assessment and Prior Authorization (Pa) Request - a form released and collected by the Nevada Department of Health and Human Services. An up-to-date fillable Form FA-1B is available for download through this link.

FAQ

Q: What is Form FA-1B?
A: Form FA-1B is a Mobility Assessment and Prior Authorization (PA) Request form in Nevada.

Q: What is the purpose of Form FA-1B?
A: The purpose of Form FA-1B is to request prior authorization for mobility aids and equipment in Nevada.

Q: Who can use Form FA-1B?
A: Form FA-1B can be used by Medicaid participants in Nevada who need prior authorization for mobility aids and equipment.

Q: What information is required on Form FA-1B?
A: Form FA-1B requires information such as the participant's name, Medicaid ID, diagnosis, and justification for the mobility aid or equipment.

Q: How long does it take to get a response to a Form FA-1B request?
A: It typically takes up to 30 days to receive a response to a Form FA-1B request, but urgent requests may be expedited.

Q: Can I appeal a denial of a Form FA-1B request?
A: Yes, you can appeal a denial of a Form FA-1B request by following the appeals process outlined by Nevada Medicaid.

Q: Is there a fee for submitting Form FA-1B?
A: No, there is no fee for submitting Form FA-1B in Nevada.

Q: Can I submit additional documents with Form FA-1B?
A: Yes, you can submit additional documents such as medical records or prescriptions to support your request on Form FA-1B.