Preauthorization Request for Services for State Fund Workers' Compensation Patients

Preauthorization Request for Services for State Fund Workers'' Compensation Patients - (Forms/Publications)
Document Information
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Title Preauthorization Request for Services for State Fund Workers'' Compensation Patients (104 KB DOC)
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

Detail
Form number F242-397-000
Availability
Online only. See document above to download.
Keywords authorization, authorization, preauthorization, preauthorization
Languages English
Valid dates 01-2014
Contact information Managing Injured Workers' Claims
Web pages To find out what services must be authorized

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