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By fax. Complete the Texas standard prior authorization request form (PDF). Then, fax the form to 1-866-835-9589.
The process for requesting services for a member in the hospital: Complete the Texas standard prior authorization request form (PDF). Fax the completed form to 1-866-706-0529.
Except for emergency services, post-stabilization services, and services provided to you during an approved inpatient admission, all services from an out-of-network provider must be prior authorized. Claims for services from out-of-network providers that are not approved before the service is given may be denied.
Make and document an eligibility decision on an application as soon as all required verification is received. Time frame for eligibility determination: Make an eligibility decision within 45 days on applications from applicants 65 years or older.
The prior authorization process begins when a service prescribed by a patients physician is not covered by their health insurance plan. Communication between the physicians office and the insurance company is necessary to handle the prior authorization.
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People also ask

No pre-authorization is required for outpatient emergency services as well as Post-stabilization Care Services (services that the treating physician views as medically necessary after the emergency medical condition has been stabilized to maintain the patients stabilized condition) provided in any Emergency Department

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