11+ Prior Authorization Form Examples in PDF | MS Word


Patients may have encountered this kind of form when they are going to admit themselves to a hospital or a health center. Whether the patient is an outpatient or an inpatient, they are often asked if they have health insurance. To make sure that any medication they need for their health and well-being is going to be correct and they will need it based on the prescription they are handed over. It is a known fact that prior authorization forms have their types and to be sure which form you are filling out, check out the following examples below.

11+ Prior Authorization Form Examples

1. Prior Authorization Form

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Size: 137 KB

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2. Standardized Prior Authorization Request Form

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Size: 272 KB

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3. Prior Authorization Request Form

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Size: 273 KB

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4. Medical Prior Authorization Request Form

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Size: 79 KB

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5. Pharmacy Prior Authorization Form

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Size: 1 MB

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6. General Prior Authorization Request Form

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Size: 512 KB

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7. Prior Authorization Form Sample

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Size: 92 KB

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8. Prior Authorization and Referral Request Form

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Size: 49 KB

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9. Pharmacy Prior Authorization Request Form Example

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Size: 56 KB

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10. Prior Authorization Request and Notification Form

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Size: 73 KB

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11. Prior Authorization Form Example

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Size: 82 KB

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12. Prior Authorization Form in DOC

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Size: 21 KB

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What Is a Prior Authorization Form?

A prior authorization form is a piece of document that health centers provide and give to insurance companies. Prior authorization forms are documents given by health care to the insurance company the patient is a member. Healthcare providers hand in prior authorizations to insurance companies for the insurance companies to fill out how much of a patient’s insurance can cover their medications. These forms are used as a means of getting approval from the insurance company whether or not their insurance covers the medications, treatment, and medical equipment. 

How to Make a Prior Authorization Form

It is a known fact that a prior authorization form is needed when it comes to patients seeking help from their insurance companies for their medical bills. For this to happen, the form is made for the insurance company to fill out for the patient. With that, here are steps to creating a prior authorization form from scratch.

Step 1: Create or Edit a Blank Template

The required information will include the medical reasons for wanting to ask for authorization from the insurance company, the medicines, the prices of medical equipment, and the required instructions of what should be filled out and how it should be filled out. As well as who they have to send it back to when it is completed.

Step 2: Add the Required Information

The required information will include the medical reasons for wanting to ask for authorization from the insurance company, the medicines, the prices of medical equipment and of course the required instructions of what should be filled out and how it should be filled out. As well as who they have to send it back when it is completed.

Step 3: The Complete Information of the Patient

Next is to add the complete information of the patient in question. This includes their complete name, address, contact details, and even their medical history. A medical history is needed to know if the patient is allergic to any medications that are going to be added or bought for the patient.

Step 4: Check for Any Revisions to Be Made

Lastly, check for any revisions to be made before you hand over the form. As this is an important document that will help a patient, when you make this, make sure to check if there is any information that you may have missed out. Proofreading a form should not take a lot of effort or time, and it is always best to be sure of your information.

FAQs

What is a prior authorization form?

Prior authorization forms are documents given by health care to the insurance company the patient is a member. Healthcare providers hand in prior authorizations to insurance companies for the insurance companies to fill out how much of a patient’s insurance can cover their medications.

Who gives out these kinds of forms?

You can expect this kind of form from health care. They give out the form to your insurance company to see how much of your insurance is covered. This includes medications, the medical bills, and any medical equipment needed.

How do you make a prior authorization form?

To make a prior authorization form from scratch, you must first create a document in Word. Next, you will add some information that is required for the document to be complete.

Patients may have encountered this kind of form when they are going to admit themselves to a hospital or a health center, a document that they may get from their insurance company from the health center or hospital. This piece of paper is a form that gives their insurance company the authority to show how much of their insurance is going to be taken to pay for their medical bills. 

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