Form FA-12 Inpatient Mental Health Prior Authorization - Nevada

What Is Form FA-12?

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-12?A: Form FA-12 is a prior authorization form for inpatient mental health services in Nevada.

Q: Who needs to complete Form FA-12?A: The healthcare provider or facility requesting inpatient mental health services needs to complete Form FA-12.

Q: What is the purpose of completing Form FA-12?A: The purpose of completing Form FA-12 is to obtain prior authorization for inpatient mental health services in Nevada.

Q: What information is required on Form FA-12?A: Form FA-12 requires information about the patient, the healthcare provider/facility, the requested services, and supporting documentation.

Q: How long does it take to process Form FA-12?A: The processing time for Form FA-12 can vary, but it is typically within a few business days.

Q: What if Form FA-12 is denied?A: If Form FA-12 is denied, the healthcare provider/facility may appeal the decision or explore alternative options.

Q: Are there any fees associated with Form FA-12?A: There are no fees associated with submitting Form FA-12 for inpatient mental health services.