Prior Auth Required

11018 - ● A completed PA/RF (Prior Authorization Request Form, F- (05/13)) (or PA/DRF (Prior Authorization/Dental

This procedure appears on the selected insurer prior authorization source.

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Prior authorizationPrior Auth Required
Procedure / Service● A completed PA/RF (Prior Authorization Request Form, F- (05/13)) (or PA/DRF (Prior Authorization/Dental
Procedure / Service Description

ForwardHealth Portal or to submit the following via fax or mail - ForwardHealth Portal or to submit the following via fax or mail: ● A completed PA/RF (Prior Authorization Request Form, F-11018 (05/13)) (or PA/DRF (Prior Authorization/Dental Request Form, F-11035 (07/12)), or PA/HIAS1 (Prior Authorization Request for Hearing Instrument and Audiological Services 1, F-11020 (05/13))).

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.