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Qaf no authorization required form medicaid

Qaf no authorization required form medicaid 2025

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The document outlines the QAF-No Authorization Required Form for Medicaid, effective from August 1, 2017. It is intended for primary care providers to refer patients to participating specialists or diagnostic centers for specific medical services without prior authorization. The form includes sections for patient and provider information, diagnosis codes, and a list of eligible procedures across various specialties such as cardiology, dermatology, neurology, and more. It emphasizes that the form is valid for 90 days and provides contact information for inquiries.

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