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.
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.
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.