Form FA-82 Prior Authorization Request - Stelara (Ustekinumab) - Nevada

Form FA-82 Prior Authorization Request - Stelara (Ustekinumab) - Nevada

What Is Form FA-82?

This is a legal form that was released by the Nevada Department of Health and Human Services - a government authority operating within Nevada. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form FA-82?A: Form FA-82 is a Prior Authorization Request form for Stelara (Ustekinumab) in Nevada.

Q: What is Stelara (Ustekinumab)?A: Stelara (Ustekinumab) is a medication used to treat certain autoimmune conditions.

Q: What is the purpose of the Prior Authorization Request form?A: The Prior Authorization Request form is used to obtain approval from the insurance provider for coverage of Stelara (Ustekinumab).

Q: Who can use the Prior Authorization Request form?A: The Prior Authorization Request form can be used by healthcare providers in Nevada.

Q: What information is required on the form?A: The form requires healthcare providers to provide patient information, diagnosis, and justification for the use of Stelara (Ustekinumab).

Q: How long does the prior authorization process take?A: The length of the prior authorization process may vary, but it typically takes several business days.

Q: What happens after the form is submitted?A: After the form is submitted, the insurance provider will review the information and make a decision on coverage for Stelara (Ustekinumab).

Q: What should I do if the prior authorization is denied?A: If the prior authorization is denied, you can work with your healthcare provider to explore other treatment options or file an appeal with the insurance company.

Q: Is there a fee for submitting the Prior Authorization Request?A: There is usually no fee for submitting the Prior Authorization Request form.

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Form Details:

  • Released on August 23, 2017;
  • 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;
  • Fill out the form in our online filing application.

Download a fillable version of Form FA-82 by clicking the link below or browse more documents and templates provided by the Nevada Department of Health and Human Services.

Download Form FA-82 Prior Authorization Request - Stelara (Ustekinumab) - Nevada

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