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 the HCA13-849 Removable Prosthetic Prior Authorization Form?
A: The HCA13-849 Removable Prosthetic Prior Authorization Form is a form used in Washington for obtaining prior authorization for removable prosthetic devices.
Q: Who needs to use the HCA13-849 Removable Prosthetic Prior Authorization Form?
A: Healthcare providers in Washington who want to request prior authorization for removable prosthetic devices need to use this form.
Q: How do I fill out the HCA13-849 Removable Prosthetic Prior Authorization Form?
A: The form requires healthcare providers to provide information about the patient, the specific removable prosthetic device being requested, and supporting clinical documentation. It is important to fill out all relevant sections accurately and completely.
Q: What is the purpose of the HCA13-849 Removable Prosthetic Prior Authorization Form?
A: The purpose of this form is to obtain prior authorization from the Washington State Health Care Authority for the provision of removable prosthetic devices to ensure proper coverage and reimbursement.
Q: Are there any fees associated with submitting the HCA13-849 Removable Prosthetic Prior Authorization Form?
A: No, there are no fees associated with submitting this form. However, the cost of the device and any necessary services may apply.
Form Details:
Download a printable version of Form HCA13-849 by clicking the link below or browse more documents and templates provided by the Washington State Health Care Authority.