This version of the form is not currently in use and is provided for reference only. Download this version of Instructions for Form FA-16B for the current year.
This document contains official instructions for Form FA-16B , Home Health Agency - Private Duty Nursing (Pdn) Services Only Prior Authorization Request - a form released and collected by the Nevada Department of Health and Human Services. An up-to-date fillable Form FA-16B is available for download through this link.
Q: What is Form FA-16B for?
A: Form FA-16B is used to request prior authorization for Home Health Agency - Private Duty Nursing (PDN) Services Only in Nevada.
Q: What is Home Health Agency - Private Duty Nursing (PDN) Services?
A: Home Health Agency - Private Duty Nursing (PDN) Services refer to skilled nursingservices provided by a registered nurse or a licensed practical nurse on a continuous hourly basis.
Q: Who needs to use Form FA-16B?
A: Providers who offer Home Health Agency - Private Duty Nursing (PDN) Services in Nevada need to use Form FA-16B to request prior authorization.
Q: What information is required on Form FA-16B?
A: Form FA-16B requires information such as the patient's name, Medicaid ID, medical diagnosis, prescribed PDN services, and other relevant details.
Q: How should I submit Form FA-16B?
A: Form FA-16B can be submitted electronically through the Nevada Medicaid Management Information System (NV MMIS) or via mail.
Instruction Details:
Download your copy of the instructions by clicking the link below or browse hundreds of other forms in our library of forms released by the Nevada Department of Health and Human Services.