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Form HCA13-739 Vision Care Authorization Request - Washington
What Is Form HCA13-739?
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.
FAQ
Q: What is Form HCA13-739?
A: Form HCA13-739 is a Vision Care Authorization Request specifically designed for Washington.
Q: What is the purpose of Form HCA13-739?
A: The purpose of Form HCA13-739 is to request authorization for vision care services in the state of Washington.
Q: Who needs to fill out Form HCA13-739?
A: Form HCA13-739 needs to be filled out by the patient or the patient's authorized representative to request authorization for vision care services.
Q: What information is required on Form HCA13-739?
A: Form HCA13-739 requires information such as patient's personal details, health insurance information, details about the vision care services requested, and any supporting documentation.
Form Details:
- Released on February 1, 2013;
- The latest edition provided by the Washington State Health Care Authority;
- 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 printable version of Form HCA13-739 by clicking the link below or browse more documents and templates provided by the Washington State Health Care Authority.
