This version of the form is not currently in use and is provided for reference only. Download this version of Form FA-1 for the current year.
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-1?
A: Form FA-1 is a durable medical equipment prior authorization request form.
Q: What is durable medical equipment?
A: Durable medical equipment refers to medical devices or equipment used for medical purposes, such as wheelchairs, crutches, and hospital beds.
Q: Why is a prior authorization request required?
A: A prior authorization request is required to ensure that the requested durable medical equipment meets the necessary criteria for coverage and payment.
Q: Who needs to fill out Form FA-1?
A: Form FA-1 should be completed by the healthcare provider or supplier requesting prior authorization for durable medical equipment.
Q: What information is required on Form FA-1?
A: Form FA-1 requires information about the patient, healthcare provider, and details about the requested durable medical equipment.
Q: How long does it take to get a prior authorization?
A: The processing time for a prior authorization request can vary, but it typically takes a few days to a few weeks to receive a decision.
Q: What happens after the prior authorization is approved?
A: Once the prior authorization is approved, the healthcare provider or supplier can proceed with ordering and providing the durable medical equipment.
Q: What happens if the prior authorization is denied?
A: If the prior authorization is denied, the healthcare provider or supplier may need to submit additional information or explore alternative options for obtaining the durable medical equipment.
Q: Are there any limitations or restrictions on durable medical equipment coverage?
A: Coverage for durable medical equipment may be subject to certain criteria, limitations, or restrictions, which vary depending on the specific health insurance plan and policy.
Form Details:
Download a fillable version of Form FA-1 by clicking the link below or browse more documents and templates provided by the Nevada Department of Health and Human Services.