Form FA-11D Substance Abuse / Behavioral Health Authorization Request - Nevada

What Is Form FA-11D?

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.

FAQ

Q: What is the Form FA-11D?
A: Form FA-11D is the Substance Abuse/Behavioral Health Authorization Request form in Nevada.

Q: What is the purpose of Form FA-11D?
A: The purpose of Form FA-11D is to request authorization for substance abuse or behavioral health services in Nevada.

Q: What information do I need to provide on Form FA-11D?
A: You will need to provide your personal information, diagnosis, recommended treatment, and any supporting documentation.

Q: Is there a deadline for submitting Form FA-11D?
A: There is no specific deadline for submitting Form FA-11D, but it is recommended to submit it as soon as possible to avoid any delays in authorization.

Q: What happens after I submit Form FA-11D?
A: After you submit Form FA-11D, the MCO will review your request and determine if authorization for the requested services is granted.

Q: Can I appeal if my request for authorization is denied?
A: Yes, if your request for authorization is denied, you have the right to appeal the decision through the MCO's appeals process.