Prior Auth Required

13470 - (10/08)). Providers are required to indicate an ACN (attachment control number) for paper attachment(s) submitted with

This procedure appears on the selected insurer prior authorization source.

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Prior authorizationPrior Auth Required
Procedure / Service(10/08)). Providers are required to indicate an ACN (attachment control number) for paper attachment(s) submitted with
Procedure / Service Description

Submitting Paper Attachments with Electronic Claims - Paper attachments that go with electronic claim transactions must be submitted with the Claim Form Attachment Cover Page (F- 13470 (10/08)). Providers are required to indicate an ACN (attachment control number) for paper attachment(s) submitted with electronic claims. (The ACN is an alphanumeric entry between 2 and 80 digits assigned by the provider to identify the attachment.) The ACN must be indicated on the cover page so that ForwardHealth can match the paper attachment(s) to the

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.