This document contains official instructions for Form F-11020 , Prior Hearing Instrument and Audiological Services (Pa/Hias1) - a form released and collected by the Wisconsin Department of Health Services. An up-to-date fillable Form F-11020 is available for download through this link.
Q: What is Form F-11020?
A: Form F-11020 is the Prior Authorization Request for Hearing Instrument and Audiological Services (PA/HIAS) form in Wisconsin.
Q: What is the purpose of Form F-11020?
A: The purpose of Form F-11020 is to request prior authorization for hearing instrument and audiological services in Wisconsin.
Q: Who should use Form F-11020?
A: Healthcare providers, hearing instrument providers, and audiologists should use Form F-11020 to request prior authorization for hearing instrument and audiological services.
Q: What information is required on Form F-11020?
A: Form F-11020 requires information such as patient's demographics, medical history, provider information, and details of the requested services.
Q: Is there a fee for submitting Form F-11020?
A: There is no fee for submitting Form F-11020.
Q: How long does it take to process Form F-11020?
A: The processing time for Form F-11020 may vary, but it is typically within 20 business days.
Q: Can Form F-11020 be submitted electronically?
A: Yes, Form F-11020 can be submitted electronically through the Wisconsin Medicaid Electronic Health Records (EHR) Incentive Program portal.
Q: Are there any additional requirements for submitting Form F-11020?
A: Yes, additional documentation such as supporting clinical records may be required along with Form F-11020.
Q: Who should I contact for further assistance with Form F-11020?
A: For further assistance with Form F-11020, you can contact the Wisconsin Medicaid and BadgerCare Plus Provider Services or the local Medicaid or BadgerCare Plus managed care organization.
Instruction Details:
Download your copy of the instructions by clicking the link below or browse hundreds of other forms in our library of forms released by the Wisconsin Department of Health Services.