INTERPRETIVE OR POLICY STATEMENT
SOCIAL AND HEALTH SERVICES
Division of Legal Services
Subject: Synagis¦ (2010 - 2011 respiratory syncytial virus (RSV) season): Administration and Authorization Requirements.
Effective Date: December 1, 2010.
Document Description: Effective for dates of service on and after December 1, 2010, DSHS will require providers to use a ProviderOne – compatible authorization form when submitting a request for Synagis¦.
To receive a copy of the interpretive or policy statements, contact Amber Dassow, HRSA, P.O. Box 45504, 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.