Instructions for Form F-11066 Prior Authorization / Oxygen Attachment (Pa / OA) - Wisconsin

Form F-11066 Prior Authorization/Oxygen Attachment (Pa/OA) - Wisconsin

This document contains official instructions for Form F-11066 , Prior Authorization/Oxygen Attachment (Pa/OA) - a form released and collected by the Wisconsin Department of Health Services. An up-to-date fillable Form F-11066 is available for download through this link.

FAQ

Q: What is Form F-11066?
A: Form F-11066 is the Prior Authorization/Oxygen Attachment (Pa/OA) form.

Q: When is Form F-11066 used?
A: Form F-11066 is used for requesting prior authorization for oxygen therapy in Wisconsin.

Q: What is prior authorization?
A: Prior authorization is the approval process required by the insurance company before they will cover the cost of oxygen therapy.

Q: How do I fill out Form F-11066?
A: You must provide all requested information on the form, including your personal information, the prescribing doctor's information, and details about your medical condition and need for oxygen therapy.

Q: What documentation do I need to include with Form F-11066?
A: You may need to include supporting documentation, such as medical records or a prescription, depending on the specific requirements of your insurance company.

Q: How long does it take to get a response after submitting Form F-11066?
A: The response time can vary, but it is typically within 14 business days.

Q: What if my request for prior authorization is denied?
A: If your request is denied, you have the right to file an appeal with your insurance company to have the decision reviewed.

Q: Can I start oxygen therapy before receiving prior authorization?
A: It is not recommended to begin oxygen therapy without first obtaining prior authorization, as you may be responsible for all costs if it is not approved.