PDF
Word
Instructions for Form F-01629 Prior Authorization / Behavioral Treatment Attachment (Pa / Bta) - Wisconsin
This document contains official instructions for Form F-01629 , Prior Authorization/Behavioral Treatment Attachment (Pa/Bta) - a form released and collected by the Wisconsin Department of Health Services. An up-to-date fillable Form F-01629 is available for download through this link.
FAQ
Q: What is Form F-01629?
A: Form F-01629 is Prior Authorization/Behavioral Treatment Attachment (Pa/Bta) for Wisconsin.
Q: What is the purpose of Form F-01629?
A: The purpose of Form F-01629 is to request prior authorization for behavioral treatment.
Q: Who needs to fill out Form F-01629?
A: Healthcare providers who are requesting prior authorization for behavioral treatment need to fill out Form F-01629.
Q: What information is required on Form F-01629?
A: Form F-01629 requires information about the patient, the treatment being requested, and the healthcare provider.
Q: Are there any fees associated with Form F-01629?
A: There are no fees associated with Form F-01629.
Q: What is the deadline for submitting Form F-01629?
A: The deadline for submitting Form F-01629 depends on the specific requirements of the healthcare provider and the treatment being requested.
Instruction Details:
- This 5-page document is available for download in PDF;
- Actual and applicable for the current year;
- Complete, printable, and free.
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.
Download Instructions for Form F-01629 Prior Authorization / Behavioral Treatment Attachment (Pa / Bta) - Wisconsin
1
2
3
4
5
