HCFA 487 forms for physician's orders. The HCFA 486 contains data which is often essential for determining the medical necessity of care ordered in the HCFA 485. The PA request may be sent to Wisconsin Medicaid before obtaining the physician's signature on the physician's orders. Obtain dated and signed physician orders within 20 days of the issuance of the order and keep on file in the recipient's medical record. Obtain physician's orders for ongoing cases before the previous orders expire.
Services provided without properly documented orders are subject to recoupment.
This allows some flexibility in the schedule of service and reduces the need for PA amendments. Housekeeping activities could be completed in one visit, if the recipient agrees, instead of being spread out over the week. However, limitations, as described in the Covered Services section, apply. Facsimiles will not be accepted. The number identifies the service on the billing claim form as a service that has been prior authorized and must be used for claim submission on all claims.