INTERPRETIVE OR POLICY STATEMENT
SOCIAL AND HEALTH SERVICES
Division of Legal Services
Subject: New DSHS form to initiate request for prior authorization.
Effective Date: February 1, 2010.
Document Description: Effective for dates of service on and after February 1, 2010, DSHS requires all providers to use the new general information for authorization form, DSHS 13-835, when initiating a request for prior authorization (PA).
This memo also reminds providers of the requirement to complete ProviderOne registration.
To receive a copy of the interpretive or policy statements, contact Amber Dassow, HRSA, P.O. Box 5504, phone (360) 725-1349, TDD/TTY 1-800-848-5429, fax (360) 586-9727, e-mail email@example.com, web site http://hrsa.dshs.wa.gov.