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2012 Texas Medicaid Provider Procedures Manual

Volume 1, General Information : Section 5: Fee-for-Service Prior Authorizations : 5.5 Prior Authorization Submission Methods : 5.5.2 Prior Authorization Requests to TMHP by Fax, Telephone, or Mail

When submitting prior authorization requests through fax or mail, providers must submit the requests on the approved form. If necessary, providers may submit attachments with the form. Providers must follow the guidelines and requirements listed in the handbook for the service. Providers can refer to the provider handbooks for the guidelines and requirements listed for a specific service.
Prior authorization requests must be signed and dated by a physician or dentist who is familiar with the client's medical condition before the request is submitted to TMHP. When allowed, prior authorizations must be signed and dated by an advanced practice registered nurse (APRN) or physician assistant (PA) who is familiar with the client’s medical condition before the request is submitted to TMHP. Prior authorization requests for services that may be signed by a licensed health-care provider other than a physician, dentist, or when allowed by an APRN and PA, do not require handwritten signatures and dates. Electronic signatures from a registered nurse (RN) or therapist are acceptable when submitting therapy requests for CCP.
All signatures and dates must be current, unaltered, and handwritten. Computerized or stamped signatures and dates are not permitted. Prior authorization requests that are submitted without a handwritten signature and date will be denied. TMHP will not authorize any dates of services on the request earlier than the date of the provider's signature. The prior authorization request that contains the original signature must be kept in the client's medical record for future access and possible retrospective review. These documentation requirements also apply to telephone authorizations. To avoid delays, providers are encouraged to have all clinical documentation at the time of the initial telephone authorization request.

Texas Medicaid & Healthcare Partnership
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