Form FA-159 High Dollar Claim Prior Authorization Request Form - Nevada

What Is Form FA-159?

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 FA-159 Form?
A: The FA-159 form is the High Dollar Claim Prior Authorization Request form.

Q: What is the purpose of the FA-159 Form?
A: The purpose of the FA-159 form is to request prior authorization for high dollar claims in Nevada.

Q: Who needs to fill out the FA-159 Form?
A: The FA-159 form should be filled out by individuals or providers requesting authorization for high dollar claims.

Q: Are there any specific requirements for filling out the FA-159 Form?
A: Yes, there are specific requirements for filling out the FA-159 form, such as providing detailed information about the claim and supporting documentation.

Q: What is a high dollar claim?
A: A high dollar claim refers to a medical claim that exceeds a certain predetermined amount, as defined by the insurance provider or state regulations.

Q: Why do high dollar claims require prior authorization?
A: High dollar claims require prior authorization to ensure that the services or treatments being requested are medically necessary and appropriate.

Q: What happens after the FA-159 Form is submitted?
A: After the FA-159 form is submitted, it will be reviewed by the appropriate authority to determine whether the prior authorization request for the high dollar claim should be approved or denied.