Form FA-156 Short-Acting Bronchodilator Quantity Limit Prior Authorization Request Form - Nevada

What Is Form FA-156?

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-156?
A: The Form FA-156 is a prior authorization request form for short-acting bronchodilators.

Q: What is a short-acting bronchodilator?
A: A short-acting bronchodilator is a medication used to provide immediate relief of symptoms in people with respiratory conditions such as asthma or chronic obstructive pulmonary disease (COPD).

Q: What is the purpose of the Form FA-156?
A: The purpose of the Form FA-156 is to request prior authorization for a specific quantity of short-acting bronchodilators for a patient in Nevada.

Q: Why is prior authorization necessary?
A: Prior authorization is necessary to ensure appropriate and cost-effective use of medications, as well as to prevent misuse or overuse of certain medications.

Q: Who needs to fill out the Form FA-156?
A: The Form FA-156 should be filled out by healthcare providers who are requesting authorization for a specific quantity of short-acting bronchodilators for their patients in Nevada.

Q: Are there any restrictions on the quantity of short-acting bronchodilators?
A: Yes, there may be quantity limits on the amount of short-acting bronchodilators that can be prescribed. The Form FA-156 is used to request authorization for quantities that exceed these limits.

Q: Is prior authorization guaranteed?
A: Prior authorization is not guaranteed, as it is subject to review and approval by the insurance provider or Medicaid program. The decision is based on medical necessity and other specified criteria.

Q: What happens if the Form FA-156 is approved?
A: If the Form FA-156 is approved, the healthcare provider will receive authorization for the requested quantity of short-acting bronchodilators for their patient.

Q: What happens if the Form FA-156 is denied?
A: If the Form FA-156 is denied, the healthcare provider may need to explore alternative treatment options or appeal the decision, if applicable.