Prior authorization

Effective for dates of service July 1, 2020, and after, hospital outpatient department (HOPD) providers will need to obtain prior authorization (PA) for panniculectomy, excision of excess skin and…

Botulinum toxins are potent neuromuscular blocking agents that are useful in treating various focal muscle spastic disorders and excessive muscle contractions, such as dystonia, spasms, and twitches.

Nasal surgery is any procedure performed on the external or internal structures of the nose, septum or turbinate.

Botulinum toxins are potent neuromuscular blocking agents that are useful in treating various focal muscle spastic disorders and excessive muscle contractions, such as dystonia, spasms, and twitches.

Effective for dates of service July 1, 2020, and after, hospital outpatient department (HOPD) providers will need to obtain prior authorization (PA) for panniculectomy, excision of excess skin and…

Nasal surgery is any procedure performed on the external or internal structures of the nose, septum or turbinate.

Physician certification statements (PCS) are required for patients who are under the direct care of a physician and are required to verify the medical necessity for certain scheduled and unscheduled…

View these submission guidelines when submitting prior authorization requests for certain hospital outpatient department services.

View these submission guidelines when submitting prior authorization requests for certain hospital outpatient department services.

Hospital outpatient departments that qualify for an exempt status effective January 1, need to have at least 10 claims submitted and finalized.