Form FA-16A Intermittent Services Prior Authorization Request - Home Health Agency - Nevada

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Form FA-16A Intermittent Services Prior Authorization Request - Home Health Agency - Nevada

What Is Form FA-16A?

This is a legal form that was released by the Nevada Department of Health and Human Services - a government authority operating within Nevada. Check the official instructions before completing and submitting the form.

FAQ

Q: What is Form FA-16A?
A: Form FA-16A is the Intermittent Services Prior Authorization Request for Home Health Agency in Nevada.

Q: What is the purpose of Form FA-16A?
A: The purpose of Form FA-16A is to request prior authorization for intermittent services from a home health agency.

Q: Who should use Form FA-16A?
A: Home health agencies in Nevada should use Form FA-16A to request prior authorization for intermittent services.

Q: What type of services are covered by Form FA-16A?
A: Form FA-16A covers intermittent services provided by home health agencies.

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Form Details:

  • Released on January 29, 2018;
  • The latest edition provided by the Nevada Department of Health and Human Services;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

Download a fillable version of Form FA-16A by clicking the link below or browse more documents and templates provided by the Nevada Department of Health and Human Services.

Download Form FA-16A Intermittent Services Prior Authorization Request - Home Health Agency - Nevada

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