Care Management Programs Department PT, OT - Beyond Therapy - Document - PDFSEARCH.IO

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	Care Management Programs Department PT, OT & ST* Request Form For Benefit Extensions beyond 25 visits/calendar year Separate Request Form for each discipline must be used Fax completed form to[removed]Include In Add to Reading List Document Date: 2012-07-12 11:50:12 Open Document File Size: 265,70 KB Share Result on Facebook City Member / / IndustryTerm speech/language pathology services / / MedicalTreatment surgery / Physical therapy / occupational therapy / / Organization Facility/Vendor Providing Service / Fund’s Pre-Authorization Call Center / / / Position Physician / / URL www.1199SEIUBenefits.org / / SocialTag Rehabilitation medicine Fax Office equipment Medicine Technology Occupational therapy

Care Management Programs Department PT, OT & ST* Request Form For Benefit Extensions beyond 25 visits/calendar year Separate Request Form for each discipline must be used Fax completed form to[removed]Include InAdd to Reading List