Ascension Complete Prior Authorization Form

Ascension Complete Prior Authorization Form - 1 Ascension Complete Quick Reference Guide Revised 1 1 2021 Ascension Complete Quick Reference Guide For Ordering Providers January 1 2020 Prior authorization and claims payment complaints appeals Follow the instructions on your denial letter or Explanation of Payment EOP

Prior Authorization Process There are two ways to obtain authorizations either through NIA s Web site at RadMD or by calling Florida 1 833 603 2971 Illinois 1 833 293 5966 Kansas 1 833 816 6623 Information Needed to Obtain Prior Authorization

Ascension Complete Prior Authorization Form

Ascension Complete Prior Authorization Form

Fax Number: 1-866-226-1093 ; You may also ask us for a coverage determination by phone at 1-833-816-6623, TTY: 711 or through our website at ascensioncomplete.com.

Fax a completed Prior Authorization Form to 512 380 7507 Fax authorizations will need to be verified for covered services By Phone Call Ascension Care Management Insurance Holdings at 844 995 1145 Monday through Friday 8 00 a m to 7 00 p m EST By Email Email Ascension Care Management Insurance Holdings at shp authorization ascension

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We recommend that providers submit prior authorizations through the web portal via phone or via fax Decisions and notifications will be made no later than 72 hours after receipt for requests meeting the definition of Expedited fast decision and no later than 14 calendar days for requests meeting the definition for Standard

Fillable Online Prior Authorization When Do I Need It Ascension Care Fax Email Print

Prior Authorization Process There are two ways to obtain authorizations either through NIA s Web site at RadMD or by calling Florida 1 833 603 2971 Illinois 1 833 293 5966 Kansas 1 833 816 6623 Tennessee 1 800 635 2873 Michigan 1 888 864 7237 Indiana 1 800 424 4919 Alabama 1 800 424 4911

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Providers will be able to request prior authorization via the internet RadMD or by calling NIA at Tennessee 1 800 635 2873 Michigan 1 888 864 7237 Indiana 1 800 424 4919 Alabama 1 800 424 4911 Florida 1 833 603 2971 Illinois 1 833 293 5966 Kansas 1 833 816 6623 Texas 1 800 424 9226

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Appendix VI Claim Form Instructions 144 Some services require prior authorization by Ascension Complete Ascension Complete takes the privacy and confidentiality of our members health information seriously We have processes policies and procedures to comply with the Health Insurance

AUTHORIZATION FORM Expedited requests: Call 1-833-603-2971 Standard/Concurrent Requests: Fax 1-844-901-0069. For Standard (Elective Admission) requests, complete this form and FAX to 1-844-901-0069. Determination made as expeditiously as the enrollee's health condition requires, but no later than . 14. calendar days after the receipt of request.

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Ascension Complete Wellcare By Allwell is a Medicare Advantage plan that offers comprehensive benefits and personalized care to eligible seniors Learn more about the plan features eligibility and provider resources at ascensioncomplete the official website of Ascension Complete

Ascension Complete Prior Authorization Form

Appendix VI Claim Form Instructions 144 Some services require prior authorization by Ascension Complete Ascension Complete takes the privacy and confidentiality of our members health information seriously We have processes policies and procedures to comply with the Health Insurance

Prior Authorization Process There are two ways to obtain authorizations either through NIA s Web site at RadMD or by calling Florida 1 833 603 2971 Illinois 1 833 293 5966 Kansas 1 833 816 6623 Information Needed to Obtain Prior Authorization

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