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Prior authorization
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#	Item
681 $Osteoporosis / Bisphosphonates / Traumatology / Dual-energy X-ray absorptiometry / Ibandronic acid / Bone fracture / Bolus / Hip fracture / Denosumab / Medicine / Health / Osteopathies$	Division: Pharmacy Services Subject: Prior Authorization Criteria Original Development Date: Original Effective Date: Add to Reading List Source URL: www.fdhc.state.fl.us Language: English - Date: 2012-06-25 14:31:43 Osteoporosis Bisphosphonates Traumatology Dual-energy X-ray absorptiometry Ibandronic acid Bone fracture Bolus Hip fracture Denosumab Medicine Health Osteopathies
682	Plan Year 2014 CCHP Senior Program (HMO) Prior Authorization (PA) Criteria Prior Authorization: CCHP Senior Program (HMO) requires you (or your physician) to get prior authorization for certain drugs. This means that you Add to Reading List Source URL: www.cchphmo.com Language: English - Date: 2013-10-14 18:28:18 Pharmaceuticals policy Clinical pharmacology Pharmacy Health maintenance organization Managed care Medical prescription Aripiprazole Medicare Part D Formulary Pharmaceutical sciences Pharmacology Health
683	FORM # FRX024 Prior Authorization Request Form for Hepatitis B Vaccine Member Information Provider Information Patient Name ____________________________ Provider Name _____________________________ Add to Reading List Source URL: mainecarepdl.org Language: English - Date: 2012-04-02 14:07:58 Biology Viruses Vaccines Hepatitis B Health Medicine Hepatitis
684	Prior Authorization/Notification Requirements wellsense.org \| [removed]This document, outlining common services that require prior authorization or Plan notification, is for use by participating W ell Sense providers Add to Reading List Source URL: www.wellsense.org Language: English - Date: 2014-06-25 10:48:49 Phencyclidine Medicine Biochemistry Neurochemistry Probabilistic complexity theory Probabilistically checkable proof
685	Division: Pharmacy Services Subject: Prior Authorization Criteria Original Development Date: Original Effective Date: Add to Reading List Source URL: www.ahca.myflorida.com - Date: 2012-06-25 14:39:12
686	Medical Prior Authorization Request Form RESET FORM wellsense.org \| [removed]Date: Please Note: Attach supporting clinical information with all requests. Incomplete information may delay Add to Reading List Source URL: www.wellsense.org Language: English - Date: 2014-07-28 20:20:47 Origination Health Superbill Health informatics Medicine Medical diagnosis Nosology
687	Document Release Form In accordance with the Personal Information Protection Act (PIPA), the Adler School of Professional Psychology, Vancouver Campus requires authorization from its students prior to the access and/or r Add to Reading List Source URL: www.adler.edu - Date: 2013-09-13 16:10:39
688	MAINE CENTER FOR DISEASE CONTROL & PREVENTION WIC NUTRITION PROGRAM Medical Documentation for WIC Medical Formula or Medical Food/MaineCare Prior Authorization Form for Medical Formula or Medical Food Healthcare Provider Add to Reading List Source URL: mainecarepdl.org Language: English - Date: 2012-03-19 13:50:17 Milk Human development United States Department of Agriculture Federal assistance in the United States Breast milk WIC Infant formula Enfamil Breastfeeding Food and drink Infant feeding Nutrition
689	INPATIENT Complete and Fax to: [removed]Prior Authorization Fax Form Add to Reading List Source URL: www.nhhealthyfamilies.com Language: English - Date: 2013-11-13 15:03:05 Medical informatics Data privacy Health Insurance Portability and Accountability Act Privacy law Healthcare Common Procedure Coding System ICD-10 International Statistical Classification of Diseases and Related Health Problems Service Superbill Medicine Health Medical classification
690	Do outpatient services require review approval or prior authorization? Some outpatient services do require prior approval through the Department for Medicaid (DMS) designated Peer Review Organization (PRO). Emergency adm Add to Reading List Source URL: www.chfs.ky.gov - Date: 2014-10-26 16:03:08

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