Get Hrob Prior Authorization (pa) Forms And Instructions

Navigating the HROB Prior Authorization (PA) Forms and Instructions is an essential step in securing necessary services for medically high-risk pregnancies. This guide provides a clear, step-by-step process to facilitate accurate and efficient completion of these forms online.

Follow the steps to successfully complete the HROB Prior Authorization forms.

1. Click ‘Get Form’ button to access the HROB Prior Authorization form and open it in your preferred editor.
2. Begin with the SoonerCare Member Information section. Ensure that you fill in the member name, ID number, date of birth, estimated date of delivery, qualifying high-risk diagnosis code(s), and the estimated dates of service. Double-check that all member details match the records on file.
3. Proceed to the Providers Information section. Enter the name of the person referring the member, along with the Primary OB's name, Provider or NPI number, office phone, fax number, and zip code. Include the Maternal Fetal Medicine (MFM) specialist’s details as well, ensuring they are state contracted.
4. In the Treatment Plan section, check the relevant boxes for the codes requested and enter the units requested in the #Planned column. Remember that providers can request up to 3 units for certain codes and may need to circle/check the appropriate modifiers for multiple fetuses.
5. When completing the signatures and date section, ensure that the Primary OB and the MFM provider sign where required. The CH-17 form must be signed by a Board Eligible/Board Certified MFM specialist or OB-GYN.
6. Gather and attach the required documentation, including a comprehensive history and physical assessment of the mother, MFM assessment letters, and relevant lab results supporting the diagnosis.
7. Review the entire form for accuracy and completeness. Once satisfied, save the changes, then download, print, or share the form as needed.

Complete your HROB Prior Authorization forms online to ensure timely and effective medical support.