Transcription of Prior Authorization - in
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Prior Authorization - in
INDIANA HEALTH COVERAGE PROGRAMS PR O V I D E R RE F E R E N C E MO D U L E Prior Authorization L I B R A R Y R E F E R E N C E N UM B E R : P R O M O D 0 0 0 1 2 P U B L I S H E D : S E P T E M B E R 1 4 , 2 0 1 7 P O L I C I E S A N D P R O C E D U R ES A S O F M A Y 1 , 2 0 17 V E R S I O N : 2 . 0 Copyright 2017 DXC Technology Company. All rights reserved. Library Reference Number: PROMOD00012 iii Published: September 14, 2017 Policies and procedures as of May 1, 2017 Version: Revision History Version Date Reason for Revisions Completed By Policies and procedures as of October 1, 2015 Published: February 25, 2016 New document FSSA and HPE Policies and procedures as of July 1, 2016 Published: October 13, 2016 Scheduled update FSSA and HPE Policies and procedures as of July 1, 2016 (CoreMMIS updates as of February 13, 2017) Published: March 14, 2017 CoreMMIS update FSSA and HPE Policies and procedures as of May 1, 2017 Published: September 14
Prior Authorization Revision History iv Library Reference Number: PROMOD00012 Published: April 26, 2018 Policies and procedures as of February 1, 2018
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