Prior Auth Required

28642 - ©2019 WPS Health Plan, Inc. All rights reserved. JO15262 -085-1905

This procedure appears on the selected insurer prior authorization source.

Check another codeExplore policy data
Prior authorizationPrior Auth Required
Procedure / Service©2019 WPS Health Plan, Inc. All rights reserved. JO15262 -085-1905
Procedure / Service Description

» Contact information and fax numbers are also available on the prior authorization request form. Clinical - ©2019 WPS Health Plan, Inc. All rights reserved. JO15262 28642-085-1905 Arise Health Plan Prior Authorization and Referral Request Form

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.