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Instructions for Form F-11020 Prior Authorization Request for Hearing Instrument and Audiological Services (Pa / Hias1) - Wisconsin
This document contains official instructions for Form F-11020 , Prior Hearing Instrument and Audiological Services (Pa/Hias1) - a form released and collected by the Wisconsin Department of Health Services. An up-to-date fillable Form F-11020 is available for download through this link.
FAQ
Q: What is Form F-11020?A: Form F-11020 is the Prior Authorization Request for Hearing Instrument and Audiological Services (PA/HIAS) form in Wisconsin.
Q: What is the purpose of Form F-11020?A: The purpose of Form F-11020 is to request prior authorization for hearing instrument and audiological services in Wisconsin.
Q: Who should use Form F-11020?A: Healthcare providers, hearing instrument providers, and audiologists should use Form F-11020 to request prior authorization for hearing instrument and audiological services.
Q: What information is required on Form F-11020?A: Form F-11020 requires information such as patient's demographics, medical history, provider information, and details of the requested services.
Q: Is there a fee for submitting Form F-11020?A: There is no fee for submitting Form F-11020.
Q: How long does it take to process Form F-11020?A: The processing time for Form F-11020 may vary, but it is typically within 20 business days.
Q: Can Form F-11020 be submitted electronically?A: Yes, Form F-11020 can be submitted electronically through the Wisconsin Medicaid Electronic Health Records (EHR) Incentive Program portal.
Q: Are there any additional requirements for submitting Form F-11020?A: Yes, additional documentation such as supporting clinical records may be required along with Form F-11020.
Q: Who should I contact for further assistance with Form F-11020?A: For further assistance with Form F-11020, you can contact the Wisconsin Medicaid and BadgerCare Plus Provider Services or the local Medicaid or BadgerCare Plus managed care organization.
Instruction Details:
- This 3-page document is available for download in PDF;
- Actual and applicable for the current year;
- Complete, printable, and free.
Download your copy of the instructions by clicking the link below or browse hundreds of other forms in our library of forms released by the Wisconsin Department of Health Services.
Download Instructions for Form F-11020 Prior Authorization Request for Hearing Instrument and Audiological Services (Pa / Hias1) - Wisconsin
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