Instructions for Form F-11035 Prior Authorization Dental Request Form (Pa / Drf) - Wisconsin

This document contains official instructions for Form F-11035 , Prior Authorization Dental Request Form (Pa/Drf) - a form released and collected by the Wisconsin Department of Health Services.

FAQ

Q: What is Form F-11035?
A: Form F-11035 is the Prior Authorization Dental Request Form (Pa/Drf) in Wisconsin.

Q: What is Prior Authorization?
A: Prior Authorization is a process used by insurance companies to determine if a certain dental procedure or treatment is medically necessary and should be covered by the insurance.

Q: Who should use Form F-11035?
A: Form F-11035 should be used by dental providers in Wisconsin who need to request prior authorization for a dental procedure or treatment.

Q: How do I fill out Form F-11035?
A: You need to provide your personal information, details of the patient, dental procedure or treatment information, and supporting documentation as required.

Q: What supporting documentation is required with Form F-11035?
A: The supporting documentation may include X-rays, treatment plans, diagnostic reports, or any other relevant information to support the prior authorization request.

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

Q: What if my prior authorization request is denied?
A: If your prior authorization request is denied, you have the option to appeal the decision and provide any additional information or documentation to support your case.

Q: Can I still receive the dental procedure or treatment if prior authorization is denied?
A: You may still receive the dental procedure or treatment, but it may not be covered by your dental insurance, and you may be responsible for the full cost.