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Form F-01629 Prior Authorization / Behavioral Treatment Attachment (Pa / Bta) - Wisconsin
What Is Form F-01629?
This is a legal form that was released by the Wisconsin Department of Health Services - a government authority operating within Wisconsin. Check the official instructions before completing and submitting the form.
FAQ
Q: What is Form F-01629?
A: Form F-01629 is a Prior Authorization/Behavioral Treatment Attachment (Pa/Bta) used in Wisconsin.
Q: What is the purpose of Form F-01629?
A: The purpose of Form F-01629 is to request prior authorization for behavioral treatment services in Wisconsin.
Q: Who needs to complete Form F-01629?
A: Form F-01629 needs to be completed by providers who are requesting prior authorization for behavioral treatment services in Wisconsin.
Q: Is Form F-01629 specific to Wisconsin?
A: Yes, Form F-01629 is specific to Wisconsin and is used in the state for requesting prior authorization for behavioral treatment services.
Form Details:
- Released on December 1, 2019;
- The latest edition provided by the Wisconsin Department of Health Services;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form F-01629 by clicking the link below or browse more documents and templates provided by the Wisconsin Department of Health Services.
Download Form F-01629 Prior Authorization / Behavioral Treatment Attachment (Pa / Bta) - Wisconsin
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