Prior authorization form definition

Prior authorization form means a standardized, uniform
Sample 1Sample 2Sample 3
Prior authorization form means astandardized, uniform application
Sample 1Sample 2
Prior authorization form means means a single uniform
Sample 1

Examples of Prior authorization form in a sentence

  • Requirements must be met for each specific item listed within this Appendix and as specified for that item.a. Physician’s/Practitioner’s Order / Prescription.b. Prior authorization form (when indicated) - Durable Medical Equipment Prior Authorization Forms are available on the QIO-like vendor’s website at the above link.

  • Requirements must be met for each specific item listed within this Appendix and as specified for that item.a. Physician’s/Practitioner’s Order/Prescription.b. Prior authorization form (when indicated) - Durable Medical Equipment Prior Authorization Forms are available on the QIO-like vendor’s website at the above link.

  • Prior authorization form and mail or leave your physician visit your fulfillment helps satisfye gaming grip, global fulfillment strategy for aetna mail order physician fax form.

  • During school hours and at school activities, students shall not wear large coats and hoods dur- ing the school day.

  • Prior authorization form is intended to be used to submit prior authorizations requests by fax or mail.

  • Specialty physicians wishing to admit a member can call, fax, or send a Request for Prior authorization form to FHW’s Care and Utilization Management Program.

  • Physician-administered drugs (medical benefit) For physician-administered drugs that require prior authorization, fax a completed Prior authorization form for medical benefit drugs to us at 716-810-1909Please note: To facilitate the process, we recommend reviewing the criteria documents that are available on the FHW website.

  • You must inform and discuss with your manager the existence of this link which could be considered a conflict of interest.

  • Prior authorization form provided by the Medicaid program along with supporting documentation for DMEPOS services must be submitted to the Medicaid program for payment of DMEPOS services.

  • Prior authorization form included in indiana department to be enrolled in an appropriate military authority if a consent forms below.


More Definitions of Prior authorization form

Prior authorization form means a single uniform prescription drug prior authorization form used by all health insurance issuers, including any health insurance issuer pharmacy benefit managers, for the purpose of obtaining prior authorization.
Sample 1
Prior authorization form means a standardized, uniform application developed by a health insurance issuer for the purposes of obtaining prior authorization.
Sample 1

Related to Prior authorization form

  • Authorization Form means a form specified in s. 440.73.

  • Prior authorization means that we must approve the Services in advance in order for the Services to be covered.

  • UCC Filing Authorization Letter means a letter duly executed by each Loan Party authorizing the Agent to file appropriate financing statements on Form UCC-1 without the signature of such Loan Party in such office or offices as may be necessary or, in the opinion of the Agent, desirable to perfect the security interests purported to be created by each Security Agreement, each Pledge Agreement and each Mortgage.

  • Federal work authorization program means any of the electronic verification of work authorization programs operated by the United States Department of Homeland Security or any equivalent federal work authorization program operated by the United States Department of Homeland Security to verify information of newly hired employees, pursuant to the Immigration Reform and Control Act of 1986 (IRCA), D.L. 99-603.

  • Authorization Letter means a letter agreement executed by Borrower in the form of EXHIBIT A.

  • Service Authorization means that Open Ecosystem Partner needs to meet specific qualification requirements for the products included in a “Service” Product Family that Open Ecosystem Partner wants to promote and offer Services for as set out in detail in the Open Ecosystem Program Guide.

  • Application Form means any application form to be completed by subscribers for Shares as prescribed by the Company from time to time.

  • Work Authorization or "WA" means Buyer’s authorization in either electronic or tangible form for Supplier to conduct transactions under this Agreement in accordance with the applicable SOW (i.e., a purchase order, xxxx of lading, or other Buyer designated document). A SOW is a WA only if designated as such in writing by Buyer.

  • Letter of Authorization means a letter signed by an officer of the licensee on whose behalf the filing is submitted that designates filing authority to the filer.

  • Sell Authorization means that Partner needs to meet specific training and qualification requirements for the products included in an “On Premise” Product Family that Partner wants to resell as set out in detail in the PartnerEdge Program Guide and the applicable RSPI.

  • Marketing Authorization Application or “MAA” means an application to the appropriate Regulatory Authority for approval to sell the Product (but excluding Pricing Approval) in any particular country or regulatory jurisdiction.

  • Service Authorization Request means a Provider’s or Enrollee’s request to the Contractor for the provision of a service.

  • Disclosure Statement Approval Order means the Final Order approving, among other things, the adequacy of the Disclosure Statement pursuant to section 1125 of the Bankruptcy Code.

  • Product Authorizations means any and all approvals, including applicable supplements, amendments, pre- and post-approvals, clearances, licenses, notifications, registrations, certifications or authorizations of any Governmental Authority, any Regulatory Agency necessary for the preclinical or clinical testing, manufacture, development, distribution, use, storage, import, export, transport, promotion, marketing, sale or other commercialization of a Product in any country or jurisdiction.

  • certificate of authorization means a certificate of authorization issued to a professional corporation pursuant to the Public Accounting Act, 2004 to permit it to engage in the practice of public accounting;

  • ACH Authorization means the ACH Debit Authorization Agreement in substantially the form of Exhibit H.

  • Annual Information Form means a document filed by the funds with Canadian securities regulators which provides supplementary information about the funds.

  • Marketing Authorization means all approvals from the relevant Regulatory Authority necessary to market and sell a Product in any country (including without limitation all applicable pricing and governmental reimbursement approvals even if not legally required to sell Product in a country).

  • IRB approval means the determination of the IRB that the research has been reviewed and may be conducted at an institution within the constraints set forth by the IRB and by other institutional and federal requirements.

  • Bid Application Form means the form as specified in Annexure II of this E-Auction Process Information Document;

  • Letter of Transmittal and Election Form means the letter of transmittal and election form(s) to be delivered by Company to the Company Shareholders and Company RSU Holders and providing for the Company Shareholder’s and Company RSU Holders election with respect to the Consideration;

  • Spousal Consent has the meaning set forth in Section 7.19.

  • Account Application Form means the Personal Account Application Form for International Personal Banking or Wealth and Investment as applicable;

  • Required Consent has the meaning set forth in Section 4.4.

  • Election Form means the form established from time to time by the Committee that a Participant completes, signs and returns to the Committee to make an election under the Plan.

  • Consents, Clearances and Permits means all authorizations, licenses, approvals, registrations, permits, waivers, privileges, acknowledgements, agreements, or concessions required to be obtained from or provided by any concerned authority for the purpose of setting up of the generation facilities and/ or supply of power;