CA Medi-Cal Fax Cover Sheet – COHS Request for Authorization
December 30, 2024 11:13 amREQUEST FOR AUTHORIZATION At this time, we are requesting authorization to render treatment to... View more
REQUEST FOR AUTHORIZATION At this time, we are requesting authorization to render treatment to... View more
REQUEST FOR AUTHORIZATION TO PROVIDE POST-STABILIZATION SERVICES : Federal regulations require that you (1)... View more
COMPETENT REVIEWER REQUEST : Oregon law requires that all final recommendations regarding the necessity... View more
NOTIFICATION OF DISAGREEMENT OF CARE On , you notified our facility that further post-stabilization... View more
REQUEST FOR AUTHORIZATION TO PROVIDE POST-STABILIZATION SERVICES : Federal regulations require that you (1)... View more
NOTIFICATION OF DISAGREEMENT OF CARE On , you notified our facility that further post-stabilization... View more
COMPETENT REVIEWER REQUEST : Washington law requires that there is a right to request... View more
REQUEST FOR AUTHORIZATION TO PROVIDE POST-STABILIZATION SERVICES : Federal regulations require that you (1)... View more
REQUEST FOR AUTHORIZATION TO PROVIDE EMERGENCY SERVICES On , you notified our facility that... View more
NOTIFICATION OF DISAGREEMENT OF CARE On , you notified our facility that further post-stabilization... View more