FORMS
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(Please Insert the WC164 form here)
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EXPEDITED HEARING
As noted in the discussion on denial of prior authorization, the patient may approach the
Division of Administrative Hearings to request an expedited hearing when there is an
urgent need for prior authorization for health care services.
The form may be obtained at:
http://www.colorado.gov/dpa/oac/WordDocs/AppExpdHrg.doc
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CMS-1500 (08-05)
CMS – 1500 (FEDERAL) BILLING FORM IS AVAILABLE THROUGH MULTIPLE
VENDORS and AT VARIOUS WEBSITES.
PLEASE NOTE THAT A REVISED VERSION OF THE CMS 1500,
the CMS 1500 (08-05) WAS INITIATED IN 2007.
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