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Form F-11014 Attachment PA / DA2 Prior Authorization / Dental Attachment - Oral Surgery, Orthodontic, and Fixed Prosthetic Services - Wisconsin
What Is Form F-11014 Attachment PA/DA2?
This is a legal form that was released by the Wisconsin Department of Health Services - a government authority operating within Wisconsin. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form F-11014?
A: Form F-11014 is an attachment used for prior authorization and dental services in Wisconsin.
Q: What is Attachment PA/DA2?
A: Attachment PA/DA2 is a specific section of Form F-11014 that pertains to oral surgery, orthodontic, and fixed prosthetic services.
Q: What does Attachment PA/DA2 cover?
A: Attachment PA/DA2 covers oral surgery, orthodontic, and fixed prosthetic services.
Q: Who needs to fill out Form F-11014 Attachment PA/DA2?
A: Dental providers in Wisconsin need to fill out Form F-11014 Attachment PA/DA2 for prior authorization and dental services.
Form Details:
- Released on February 17, 2020;
- The latest edition provided by the Wisconsin Department of Health Services;
- 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 fillable version of Form F-11014 Attachment PA/DA2 by clicking the link below or browse more documents and templates provided by the Wisconsin Department of Health Services.
Download Form F-11014 Attachment PA / DA2 Prior Authorization / Dental Attachment - Oral Surgery, Orthodontic, and Fixed Prosthetic Services - Wisconsin
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