Navigating through the intricacies of healthcare procedures requires a keen understanding of various forms and requests, among which the Utah 24 06 37 form stands out. This form, set forth by the Utah Department of Health Medical Services, serves a pivotal role in the process of obtaining prior authorization for Medicaid recipients. Updated in April 2011, it meticulously outlines the necessary steps for healthcare providers to request authorization for medical supplies, therapies, imaging, or procedures. It explicitly instructs against its use for Molina or Healthy U requests, guiding users to contact the respective Managed Care Organization (MCO) instead. Offering detailed sections for patient information, requested service codes, estimated costs, and provider details, the form is designed to ensure that all relevant information is thoroughly provided. This process not only streamlines the authorization by the Division of Medicaid and Health Financing but also emphasizes the importance of submitting accurate and complete data to avoid delays or denials. The form’s structure—including options for retroactive requests, changes to current authorizations, and the incorporation of additional codes on subsequent pages—highlights the intricate compliance and attention to detail necessary for navigating Utah’s Medicaid system.
| Question | Answer |
|---|---|
| Form Name | Utah Form 24 06 37 |
| Form Length | 3 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 45 sec |
| Other names | PriorAuth4 11 utah medicaid request for prior authorization form |
