This is a legal form that was released by the Washington State Health Care Authority - a government authority operating within Washington. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is Form HCA13-772?
A: Form HCA13-772 is a Hearing Aid Authorization Request form specific to Washington state.
Q: What is the purpose of Form HCA13-772?
A: The purpose of Form HCA13-772 is to request authorization for hearing aid services in Washington.
Q: Who needs to fill out Form HCA13-772?
A: Form HCA13-772 needs to be filled out by individuals or their healthcare providers who are seeking authorization for hearing aid services in Washington.
Q: What information is required on Form HCA13-772?
A: Form HCA13-772 requires information such as the patient's personal details, medical diagnosis, hearing aid prescription, and the provider's information.
Q: Are there any fees associated with Form HCA13-772?
A: There may be fees associated with hearing aid services, but the specific fees and payment details are not provided on the form. It is best to contact the healthcare provider or insurance company for fee information.
Q: How long does it take to process Form HCA13-772?
A: The processing time for Form HCA13-772 may vary. It is advisable to check with the Washington Health Care Authority or the healthcare provider for an estimate on processing time.
Q: What should I do if I need help filling out Form HCA13-772?
A: If you need assistance with filling out Form HCA13-772, you can reach out to the Washington Health Care Authority or your healthcare provider for guidance and support.
Form Details:
Download a fillable version of Form HCA13-772 by clicking the link below or browse more documents and templates provided by the Washington State Health Care Authority.