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RMHP Prior Authorization List Effective October 1, 2017 V5 Revised-2026
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- Click ‘Get Form’ to open the RMHP Prior Authorization List in the editor.
- Begin by filling out the 'Ordering Provider' section. Enter the first name, middle initial, date of birth, gender, and contact information for both the patient and provider.
- In the 'Procedure' section, check all applicable CPT codes related to the diagnosis. Ensure you provide any known ICD-10 codes and details about previous surgeries if applicable.
- Complete the 'Clinical Information' section by indicating pain levels, previous treatments, and imaging studies completed. Be thorough in documenting any psychosocial or medical issues that may affect surgical outcomes.
- Review all entered information for accuracy. Use our platform's features to add comments or additional information as needed before submitting.
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Related links
Oct 2, 2017 SB17-300 requires the DOI to submit a report by October 1, 2017. This report fulfills the Risk Coverage Options. This approval is effective
This report contains the findings from these tasks ordered by subject-matter. Regional Behavioral Health Service