PDF
Word
This version of the form is not currently in use and is provided for reference only. Download this version of
Form PA-102
for the current year.
Form PA-102 Applied Behavior Analysis Therapy Prior Authorization Request Form - South Dakota
What Is Form PA-102?
This is a legal form that was released by the South Dakota Department of Social Services - a government authority operating within South Dakota. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is the Form PA-102?
A: Form PA-102 is the Applied Behavior Analysis Therapy Prior Authorization Request Form.
Q: What is Applied Behavior Analysis Therapy?
A: Applied Behavior Analysis Therapy is a type of therapy that focuses on improving specific behaviors and skills.
Q: Who can use Form PA-102?
A: Form PA-102 can be used by healthcare providers in South Dakota who are requesting prior authorization for Applied Behavior Analysis Therapy.
Q: What is the purpose of Form PA-102?
A: The purpose of Form PA-102 is to request prior authorization for Applied Behavior Analysis Therapy services.
Form Details:
- Released on December 1, 2022;
- The latest edition provided by the South Dakota Department of Social 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 PA-102 by clicking the link below or browse more documents and templates provided by the South Dakota Department of Social Services.
Download Form PA-102 Applied Behavior Analysis Therapy Prior Authorization Request Form - South Dakota
1
2
3
