Hearing Aid Repair Authorization Fax Request

Hearing Aid Repair Authorization Fax Request - (Forms/Publications)
Document Information
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Title Hearing Aid Repair Authorization Fax Request (A fillable form - 136 KB PDF)
Description

Hearing Aid Repair Authorization Requests. If you need to purchase or replace a hearing aid, fax all of the information required by Medical Aid Rules and Fee Schedule (MARFS) including the Hearing Services Worker Information (F245-049-000) to 360-902-6252.

Detail
Form number F245-384-000
Availability
Online only. See document above to download.
Keywords hearing aids, hearing authorization, hearing repair, Provider Hotline
Languages English
Valid dates 03-2014
Contact information

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