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KyHealth Choices Prior Authorization Call Checklist Prior to calling or faxing this request to prior authorize services, please complete the following information for each Medicaid member when requesting services. By
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Document Date: 2015-02-09 20:08:50
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File Size: 672,62 KB
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Facility
Facility Name /
/
/
Organization
Middle Initial Member Medicaid Zip Code Responsible Party /
Medicaid /
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Person
Medicaid Zip /
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SocialTag
Presidency of Lyndon B. Johnson
Federal assistance in the United States
Healthcare reform in the United States
Medicaid