Form FA-179 Auvi-Q Prior Authorization Request Form - Nevada

Form FA-179 Auvi-Q Prior Authorization Request Form - Nevada

What Is Form FA-179?

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 Form FA-179?
A: Form FA-179 is the Auvi-Q Prior Authorization Request Form.

Q: What is Auvi-Q?
A: Auvi-Q is a medication used for the treatment of severe allergic reactions.

Q: What is a prior authorization request form?
A: A prior authorization request form is a form that is required by insurance companies to approve the coverage of a specific medication.

Q: Why do I need to fill out Form FA-179?
A: You need to fill out Form FA-179 to request prior authorization for Auvi-Q and to ensure that it is covered by your insurance.

Q: Is Form FA-179 specific to Nevada?
A: Yes, Form FA-179 is specific to Nevada.

Q: What should I include in Form FA-179?
A: You should include your personal information, insurance information, prescribing healthcare provider information, and any supporting medical documentation.

Q: How long does it take to process a prior authorization request?
A: The processing time for a prior authorization request can vary depending on the insurance company, but it usually takes a few days to a few weeks.

Q: What happens after I submit Form FA-179?
A: After you submit Form FA-179, the insurance company will review your request and determine whether to approve or deny the coverage of Auvi-Q.

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Form Details:

  • Released on October 14, 2020;
  • The latest edition provided by the Nevada Department of 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 printable version of Form FA-179 by clicking the link below or browse more documents and templates provided by the Nevada Department of Health and Human Services.

Download Form FA-179 Auvi-Q Prior Authorization Request Form - Nevada

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