Form PT-1 Prescription for Transportation Form - Massachusetts

Form PT-1 Prescription for Transportation Form - Massachusetts

What Is Form PT-1?

This is a legal form that was released by the Massachusetts MassHealth - a government authority operating within Massachusetts. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is the Form PT-1?
A: The Form PT-1 is the Prescription for Transportation Form used in Massachusetts.

Q: What is the purpose of the Form PT-1?
A: The Form PT-1 is used to authorize transportation services for a patient in Massachusetts.

Q: Who can fill out the Form PT-1?
A: The Form PT-1 can be filled out by a physician, nurse practitioner, or licensed psychologist.

Q: What information is required on the Form PT-1?
A: The Form PT-1 requires information such as the patient's name, address, medical condition, and transportation needs.

Q: How is the Form PT-1 submitted?
A: The completed Form PT-1 can be submitted to the patient's insurance company or the transportation vendor.

Q: Are there any fees associated with the Form PT-1?
A: There may be fees associated with transportation services, but the Form PT-1 itself does not have a fee.

Q: What should I do if I have questions about the Form PT-1?
A: If you have questions about the Form PT-1, you should contact the patient's healthcare provider or insurance company.

ADVERTISEMENT

Form Details:

  • Released on May 1, 2009;
  • The latest edition provided by the Massachusetts MassHealth;
  • 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 PT-1 by clicking the link below or browse more documents and templates provided by the Massachusetts Masshealth.

Download Form PT-1 Prescription for Transportation Form - Massachusetts

4.5 of 5 (29 votes)
  • Form PT-1 Prescription for Transportation Form - Massachusetts

    1

  • Form PT-1 Prescription for Transportation Form - Massachusetts, Page 2

    2

  • Form PT-1 Prescription for Transportation Form - Massachusetts, Page 1
  • Form PT-1 Prescription for Transportation Form - Massachusetts, Page 2
Prev 1 2 Next
ADVERTISEMENT