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Form 1336 Antiviral Agents for Hepatitis C Virus Refill Authorization Request (Medicaid) - Texas
What Is Form 1336?
This is a legal form that was released by the Texas Health and Human Services - a government authority operating within Texas. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form 1336?
A: Form 1336 is a refill authorization request for antiviral agents for Hepatitis C Virus under Medicaid in Texas.
Q: What is the purpose of Form 1336?
A: The purpose of Form 1336 is to request a refill of antiviral agents for Hepatitis C Virus under Medicaid in Texas.
Q: Who can use Form 1336?
A: Form 1336 can be used by individuals who are enrolled in Medicaid in Texas and require a refill of antiviral agents for Hepatitis C Virus.
Q: What information is required on Form 1336?
A: Form 1336 requires information such as patient details, medication details, prescribing healthcare provider information, and Medicaid information.
Q: How long does it take to process Form 1336?
A: The processing time for Form 1336 may vary, but it is typically processed within a few business days.
Q: Is there a fee for submitting Form 1336?
A: There is typically no fee for submitting Form 1336, but it is always best to check with your Medicaid program for specific details.
Q: Can Form 1336 be used for other medications?
A: Form 1336 is specifically designed for refill authorization requests for antiviral agents for Hepatitis C Virus under Medicaid in Texas. It may not be applicable for other medications.
Form Details:
- Released on March 1, 2018;
- The latest edition provided by the Texas Health and Human Services;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form 1336 by clicking the link below or browse more documents and templates provided by the Texas Health and Human Services.
