Preauthorization Request for Services for State Fund Workers' Compensation Patients


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Title Preauthorization Request for Services for State Fund Workers' Compensation Patients
Description

This form can only be used for services that can be authorized by the claim manager and it should not be used for Utilization Review (Qualis), Provider Hotline or requests to the Occupational Nurse Consultant.  If you are unsure of what services need to be authorized see L&I fee lookup utility at www.Lni.wa.gov/apps/FeeSchedules/

For complete information on all authorization processes please see:  www.Lni.wa.gov/ClaimsIns/Providers/AuthRef/GetAuth.asp

Document number F242-397-000
How to get this document
Keywords authorization, authorization, preauthorization, preauthorization
Alt Language(s)
Valid dates 01/2014
Contact information Managing Injured Workers' Claims
Websites To find out what services must be authorized

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