Instructions for Form F-02567 Prior Authorization / Residential Substance Use Disorder Treatment Attachment (Pa / Rsud) - Wisconsin

Form F-02567 Prior Authorization/Residential Substance Use Disorder Treatment Attachment (Pa/Rsud) - Wisconsin

This document contains official instructions for Form F-02567 , Prior Authorization/Residential Substance Use Disorder Treatment Attachment (Pa/Rsud) - a form released and collected by the Wisconsin Department of Health Services. An up-to-date fillable Form F-02567 is available for download through this link.

FAQ

Q: What is Form F-02567?
A: Form F-02567 is the Prior Authorization/Residential Substance Use Disorder Treatment Attachment (Pa/Rsud) in Wisconsin.

Q: What is the purpose of Form F-02567?
A: The purpose of Form F-02567 is to request prior authorization for residential substance use disorder treatment in Wisconsin.

Q: Who needs to use Form F-02567?
A: Any individual or provider seeking prior authorization for residential substance use disorder treatment in Wisconsin needs to use Form F-02567.

Q: What information is required on Form F-02567?
A: Form F-02567 requires detailed information about the individual seeking treatment, the treatment facility, and the requested services.

Q: Is there a deadline for submitting Form F-02567?
A: Yes, there is a deadline for submitting Form F-02567. The specific deadline may vary depending on the individual's situation, so it is important to check with the Wisconsin Department of Health Services or the healthcare provider for the exact deadline.

Q: What happens after submitting Form F-02567?
A: After submitting Form F-02567, the request for prior authorization will be reviewed by the Wisconsin Department of Health Services or the appropriate healthcare provider. The individual will be notified of the decision regarding the request.

Q: Are there any fees associated with Form F-02567?
A: There may be fees associated with submitting Form F-02567, such as copayments or deductibles. The specific fees will depend on the individual's insurance coverage and the treatment facility.

Q: What should I do if I have additional questions about Form F-02567?
A: If you have additional questions about Form F-02567, you should contact the Wisconsin Department of Health Services or the appropriate healthcare provider for assistance.