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.
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.
Form Details:
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.