Authorization Number : 50750150
Agency Series No. : 404-63-17
Status : Active
Agency Web Link :
Agency : ODM
Confidential Description : U.S. Code of Federal Regulation, Title 5 Section 552 (H) of the Medicaid Handbook.
Division : ODMOPER
Vital Description :
Section : ODMOPERCLOP
Record Title : Prior Authorization Reviews
Revision : 1
Record Description : Used to review cases for authorizing treatment and or service for Medicaid recipients. Requests may be either approved or denied Types of treatment and/or service include: supplies; ambulance; ambulate; dental; durable medical equipment; occupational therapy; out-patient hospital visit; pharmaceuticals-drugs; food supplements; physician visits; private duty nurses; rehabilitation hospital; special committee cases; transplant; and vision care. Includes: ODHS 3142; ODSH 3612; and ODHS 3542.