PHYSICAL THERAPY/OCCUPATIONAL THERAPY AUTHORIZATION REQUEST

Physical Therapy/Occupational Therapy Authorization Request

  • Book type: PDF
  • Book size: n/a
  • Book Name: pt-and-ot-form-011205.pdf
  • Source: owcpmed.dol.gov

physical therapy/occupational therapy authorization request. physical therapy/occupational therapy authorization request fax # 1-800-215-4901 authorization request-pt ot effective 10-1-2015 all prior authorization requests must either be faxed on this template or be submitted
Physical Therapy/Occupational Therapy Authorization Request Fax # 1-800-215-4901 Authorization Request-PT OT Effective 10-1-2015 All Prior Authorization requests must either be faxed on this template or be submitted

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