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5.3.1.1 Document Requirements and Retention
If the information provided in the online request is insufficient to support medical necessity, TMHP Prior Authorization staff may request providers to submit additional paper documentation to support the medical necessity of the service or services being requested for prior authorization.
Submission of prior authorization requests on the secure pages of the TMHP website does not replace adherence to and completion of the paper forms/documentation requirements outlined in the this manual and other publications.
Documentation requirements include, but are not limited to, the following:
• Documentation that supports the medical necessity of the service requested.
•Completion and retention in the client's medical record of all required prior authorization forms
•Adherence to signature and date requirements for prior authorization forms and other required forms maintained in the client record, including the following:
•All prior authorization forms completed and signed before the online prior authorization request is made
•Original handwritten signatures (Computerized or stamped signatures are not accepted by Texas Medicaid.)
•A printed copy of the Online Request Form, which must be retained in the client's medical record
Any required documentation that is missing from the client's medical record subjects the associated services to recoupment.
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