First Name: MI: Last Name: DOB: Member ID: Physician Information . Prior authorization is the process of obtaining approval of benefits before certain prescriptions are filled. Email: ASKMEDICAID@dshs.wa.gov. Go to . Molina Healthcare of Washington Phone: (800) 213-5525 Option 1-2-2 | Fax: (800) 869-7791 Urgent . This list contains prior authorization requirements for care providers who participate with UnitedHealthcare Community Plan in Washington for inpatient and outpatient services. Washington Medicaid-Approved Preferred Drug List. Legend . QL: Quantity limits; certain prescription medications have specific quantity limits per prescription or per month (1) The expedited prior authorization process (EPA) is designed to eliminate the need for written and telephonic requests for prior authorization for selected medical equipment procedure codes. Prior authorization and medical necessity processes in fee-for-service delivery systems are established, defined and administered at state/territory discretion and may vary depending on the benefit. Molina Healthcare of Washington Medicaid Prior Authorization Request Form . This list contains prior authorization requirements for care providers who participate with UnitedHealthcare Community Plan in Washington for inpatient and outpatient services. CareFirst CHPDC is the Washington DC provider of Medicaid and Alliance Benefits. Prior authorization is required. The types of services that help an adult remain at home.. Finding other places to live and get care if the adult can no longer live at home.. Finding caregiver resources and information.. Ways to stay independent as long as possible.. Find in-depth information about the rules and laws that govern Washington State’s Medicaid program. Fax Number: (800) 767-7188 . Phone Number: (800) 869-7175 . To request prior authorization, please submit your request online or by phone. Procedures Requiring Prior Authorization. I. NFORMATION. Online: »visit the Washington State Medicaid website »visit the Authorization for Services webpage »report provider and client problems »more contact info Effective Date 1/01/20. UHCprovider.com 52018. Contact Washington State Medicaid. M. EMBER . This EA allows pharmacies to submit a claim for a seven (7) day supply without a prior authorization. Learn More About. Prior Authorization Code Search. How to apply for Medicaid.. (2) The medicaid agency requires a provider to create an authorization number for EPA for selected medical equipment procedure codes. New state rules and the WSMA Prior Authorization Navigator. • Online: Use the Prior Authorization and Notification tool on Link. Phone: (800) 562-3022 ext. Plan: Molina Medicaid Other: Member Name: DOB: / / Member ID#: Phone: ( ) - Service Type: Elective/Routine. 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