Form FA-173 Sickle Cell Anemia Agents Prior Authorization Request Form - Nevada

What Is Form FA-173?

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-173?
A: Form FA-173 is a prior authorization request form for Sickle Cell Anemia Agents.

Q: What is sickle cell anemia?
A: Sickle cell anemia is a genetic blood disorder that affects the shape of red blood cells.

Q: What are sickle cell anemia agents?
A: Sickle cell anemia agents are medications used to treat sickle cell anemia.

Q: Why is prior authorization required?
A: Prior authorization is required to ensure the appropriate use of medications and manage healthcare costs.

Q: How can I obtain Form FA-173?
A: Form FA-173 can be obtained from your healthcare provider or insurance company.

Q: Who needs to fill out Form FA-173?
A: Form FA-173 needs to be filled out by the healthcare provider prescribing the sickle cell anemia agent.

Q: What information is needed on Form FA-173?
A: Form FA-173 requires information about the patient, the prescribed medication, and the healthcare provider.

Q: Are there any specific requirements for completing Form FA-173?
A: Yes, specific requirements may vary depending on the insurance company's guidelines and policies.

Q: How long does it take for prior authorization to be approved?
A: The time for prior authorization approval can vary, but it is typically within a few business days.

Q: What if my prior authorization request is denied?
A: If your prior authorization request is denied, you may have the option to appeal the decision or explore alternative treatment options.