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Medical Tar Form PDF

Medical Tar Form PDF

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Instructions and help about california 50 1

on September 22nd 2023 PA requirements were reinstated for New Start entro nutrition products for members 22 years of age and older new starts are defined as new entral Nutrition Therapy not previously prescribed to the member During the 15-month lookback period for non- new starts claims will continue to adjudicate under the transition policy at this time entral nutrition product claims submitted for a date of service prior to September 22nd did not deny with reject code 75 PRI authorization required due to the temporary suspension of medical X's PA requirements however as part of the phase 4 lift 2 reinstatement new start claims for members 22 years of age and older will now be subject to PA requirements claims for entral nutrition products will deny for reject code 75 as all utrition product claims require a PA claims will deny for reject code 76 if the quantity requested for the product exceeds a maximum daily calorie limit of 2,000 kcals per day quantity limits will not ap

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