Instructions for Form F-11088 Prior Authorization / Health and Behavior Intervention Attachment (Pa / Hba) - Wisconsin

Form F-11088 Prior Authorization/Health and Behavior Intervention Attachment (Pa/Hba) - Wisconsin

This document contains official instructions for Form F-11088 , Prior Authorization/Health and Behavior Intervention Attachment (Pa/Hba) - a form released and collected by the Wisconsin Department of Health Services. An up-to-date fillable Form F-11088 is available for download through this link.

FAQ

Q: What is Form F-11088?
A: Form F-11088 is the Prior Authorization/Health and Behavior Intervention Attachment (Pa/Hba) form in Wisconsin.

Q: What is the purpose of Form F-11088?
A: The purpose of Form F-11088 is to request prior authorization for health and behavior interventions in Wisconsin.

Q: Who needs to fill out Form F-11088?
A: The form needs to be filled out by healthcare providers who are requesting prior authorization for health and behavior interventions.

Q: Are there any fees associated with Form F-11088?
A: No, there are no fees associated with Form F-11088.

Q: What information do I need to provide in Form F-11088?
A: You need to provide information on the patient, the requested health and behavior interventions, and supporting documentation.

Q: How long does it take to process Form F-11088?
A: The processing time for Form F-11088 may vary, but it typically takes 10 business days.

Q: Can I appeal the decision made based on Form F-11088?
A: Yes, you can appeal the decision made based on Form F-11088 by following the appeals process outlined by the Wisconsin Department of Health Services.