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Form F-11088 Prior Authorization / Health and Behavior Intervention Attachment (Pa / Hba) - Wisconsin
What Is Form F-11088?
This is a legal form that was released by the Wisconsin Department of Health Services - a government authority operating within Wisconsin. Check the official instructions before completing and submitting the form.
FAQ
Q: What is Form F-11088?A: Form F-11088 is the Prior Authorization/Health and Behavior Intervention Attachment (Pa/Hba) in Wisconsin.
Q: What is the purpose of Form F-11088?A: The purpose of Form F-11088 is to request prior authorization for health and behavior intervention services in Wisconsin.
Q: Who needs to use Form F-11088?A: Healthcare providers in Wisconsin who want to request prior authorization for health and behavior intervention services need to use Form F-11088.
Q: What information is required on Form F-11088?A: Form F-11088 requires information such as patient demographics, diagnosis codes, treatment plans, and supporting documentation.
Q: Is Form F-11088 specific to Wisconsin?A: Yes, Form F-11088 is specific to the state of Wisconsin.
Form Details:
- Released on July 1, 2012;
- The latest edition provided by the Wisconsin Department of Health 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 F-11088 by clicking the link below or browse more documents and templates provided by the Wisconsin Department of Health Services.
