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December 2016 Texas Medicaid Provider Procedures Manual

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 : 5.5.2.2 TMHP Prior Authorization Requests by Fax

5.5.2.2
Providers who fax new prior authorization requests, resubmitted requests, or additional information to complete a request must include:
 

Texas Medicaid & Healthcare Partnership
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