Submitting a Care Type

Overview


An Authorization, also known as a Prior Authorization or PA, is required for any service which meets any of the following guidelines:

  • listed in the PA List

  • DX and CPT pair Below the Line (BTL)

  • DX and CPT has no line match

  • any other service determined by the Plan


Prior Authorizations are submitted by the member's Primary Care Provider (PCP) or ancillary provider, e.g. Home Health.

Submitting a Care Type


1. Click on 'ADD NEW TYPE OF CARE'

2. Select the Applicable Care Type for What is Needed

3. Follow the Onscreen Prompts, Filling Out the Required Information




changelog
Date Summary Ticket03/30/22 Page Created n/a