Instructions for Form F-11036 Prior Authorization / Intensive in-Home Treatment Attachment (Pa / Ita) - Wisconsin

Form F-11036 Prior Authorization/Intensive in-Home Treatment Attachment (Pa/Ita) - Wisconsin

This document contains official instructions for Form F-11036 , Prior Authorization/Intensive in-Home Treatment Attachment (Pa/Ita) - a form released and collected by the Wisconsin Department of Health Services. An up-to-date fillable Form F-11036 is available for download through this link.

FAQ

Q: What is Form F-11036?
A: Form F-11036 is the Prior Authorization/Intensive in-Home Treatment Attachment (PA/ITA) form used in Wisconsin.

Q: What is the purpose of Form F-11036?
A: The purpose of Form F-11036 is to request prior authorization for intensive in-home treatment services in Wisconsin.

Q: Who should use Form F-11036?
A: Form F-11036 should be used by providers who are requesting prior authorization for intensive in-home treatment services in Wisconsin.

Q: Is Form F-11036 specific to Wisconsin?
A: Yes, Form F-11036 is specific to Wisconsin and is used for requesting prior authorization for intensive in-home treatment services in the state.

Q: Are there any fees associated with Form F-11036?
A: There are no fees associated with completing and submitting Form F-11036.

Q: What information is required on Form F-11036?
A: Form F-11036 requires information such as the patient's demographics, treatment provider information, and details of the requested intensive in-home treatment services.

Q: How long does it take to process Form F-11036?
A: The processing time for Form F-11036 may vary, but it is generally within a few business days.

Q: What should I do if I have questions or need assistance with Form F-11036?
A: If you have questions or need assistance with Form F-11036, you can contact the Wisconsin Department of Health Services for guidance.