Prior Auth Required

21244 - Reports Clearance Officer, Mail Stop C4-26-05, Baltimore, Maryland -1850

This procedure appears on the selected insurer prior authorization source.

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Prior authorizationPrior Auth Required
Procedure / ServiceReports Clearance Officer, Mail Stop C4-26-05, Baltimore, Maryland -1850
Procedure / Service Description

This number requires special telephone equipment and is only for people who - The valid OMB control number for this information collection is 0938-1051. If you have comments or suggestions for improving this form, please write to: CMS, 7500 Security Boulevard, Attn: PRA Reports Clearance Officer, Mail Stop C4-26-05, Baltimore, Maryland 21244-1850. APPENDIX A

Likely documents
  • Confirm benefit details
  • Submit clinical notes if requested by the plan
Next actions
  • Confirm the current plan policy before submission.
  • Use the insurer authorization workflow for this listed code.