Instructions for Form F-11044 Prior Authorization / Home Health Therapy / Attachment (Pa / Hhta) - Wisconsin

Form F-11044 Prior Authorization/Home Health Therapy Attachment (Pa/Hhta) - Wisconsin

This document contains official instructions for Form F-11044 , Prior Authorization/Home Health Therapy/Attachment (Pa/Hhta) - a form released and collected by the Wisconsin Department of Health Services. An up-to-date fillable Form F-11044 is available for download through this link.

FAQ

Q: What is Form F-11044?
A: Form F-11044 is the Prior Authorization/Home Health Therapy/Attachment (PA/HTHA) form for Wisconsin.

Q: What is the purpose of Form F-11044?
A: The purpose of Form F-11044 is to request prior authorization for home healththerapy services.

Q: Who needs to fill out Form F-11044?
A: Healthcare providers who are requesting prior authorization for home health therapy services need to fill out Form F-11044.

Q: What information is required on Form F-11044?
A: Form F-11044 requires information such as patient demographics, diagnoses, treatment plan, and provider information.

Q: Is Form F-11044 specific to Wisconsin?
A: Yes, Form F-11044 is specific to Wisconsin and is used for requesting prior authorization for home health therapy services in the state.

Q: Are there any fees associated with submitting Form F-11044?
A: No, there are no fees associated with submitting Form F-11044 for prior authorization of home health therapy services.

Q: What is the processing time for Form F-11044?
A: The processing time for Form F-11044 varies, but it is typically within 5 business days.

Q: What should I do if my Form F-11044 is denied?
A: If your Form F-11044 is denied, you can appeal the decision through the Wisconsin Medicaid Provider Portal or by contacting the Wisconsin Department of Health Services.