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Request for Psychological Testing Preauthorization Form ...

Request for Psychological Testing Preauthorization Form ...

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Request for Psychological Testing Preauthorization Revised 12/18 Page 1 of 3 Version 10.8 (handwritten submissions) ©2004-2018 Magellan Health, Inc. The testing provider must complete Section XI, Requested Testing and, if applicable, Section XIII, Technician Attestation.Either the

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