INTERPRETIVE OR POLICY STATEMENT
SOCIAL AND HEALTH SERVICES
Division of Legal Services
Subject: New form to initiate request for prior authorization.
Effective Date: March 1, 2010.
Document Description: In response to providers' feedback DSHS is reissuing this memo with a later effective date of March 1, 2010.
Effective for dates of service on and after March 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 firstname.lastname@example.org, web site http://hrsa.dshs.wa.gov.