Table of Contents Previous Next Index

2012 Texas Medicaid Provider Procedures Manual

Volume 1, General Information : Section 5: Fee-for-Service Prior Authorizations : 5.4 Submitting Prior Authorization Forms

5.4 Submitting Prior Authorization Forms
Providers must complete all essential fields on prior authorization forms submitted to TMHP to initiate the prior authorization process.
If essential fields are not completed, TMHP will return the original request to the provider and will document on the fax cover sheet the fields that must be completed by the provider before submitting the request to initiate the prior authorization process.
The following prior authorization request forms contain essential fields that must be completed by the provider:
The following essential fields must be completed on the CCP Prior Authorization Request Form and Home Health Services (Title XIX) DME/Medical Supplies Physician Order Form:
The CCP Prior Authorization Request Form states that if any portion of the form is incomplete, the form will be returned; however, as long as the essential fields on the form have been completed, TMHP Prior Authorization can initiate the prior authorization process.
If an essential field on any of these prior authorization forms is not completed, TMHP will send the provider a copy of the form along with a fax cover sheet that includes the following statement:
TMHP Prior Authorization could not process this request because the request form is missing (applicable essential field[s]). Please resubmit the request with this information for processing by TMHP.
If the form is returned to TMHP with all essential fields completed, TMHP will initiate the prior authorization process.

Texas Medicaid & Healthcare Partnership
CPT only copyright 2011 American Medical Association. All rights reserved.