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Get Fl Clear Spring Health Pre-service Authorization Form 2020-2024

T B drugs, please allow 24 hours for processing urgent requests and 72 hours for non-urgent requests. URGENT REQUEST I certify that this request is urgent and medically necessary to treat an illness, injury or condition (not life threatening) within 72 hours to avoid complications and unnecessary suffering or severe pain. This authorization is valid for 90 days, unless otherwise indicated. Only authorized services may be provided. Clinical documentation is required for authorization process.

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