Updates from iCare’s Prior Authorization Department
New Prior Authorization Form
The PA department has changed the Prior Authorization Request Form for DME, DMS, and Outpatient Procedures to include some critical information that will assist in the proper and accurate entry of an authorization request.
We hope these changes will make the form easier to use and will lead to better completion with less phone calls to determine incorrect or missing information. Please visit our Provider Documents page at:
https://www.icarehealthplan.org/Provider-Documents.htm to access the latest version of our Prior Authorization Request Form.
Or click: New Prior Auth Form to file a PA request.
New Prior Authorization Specific Listing
The Prior Authorization Department will be updating the Procedure Specific Listing for Q2 2021. The new Procedure Specific Listing for Q2 2020 will be effective April 1, 2021. These new PA Specific Listings can be accessed below:
New Prior Auth Specific Listing/pdf New Prior Auth Specific Listing/excel
An excel version of this document can be filtered by category, code, or description. The PDF can be searched using the F5 option.
The following codes are being removed from the list requiring PA effective April 1, 2021:
81244, 95700, 97760, 92604, 92626, 38221
The following codes will be added to the list requiring PA effective April 1, 2021:
G2168, G2169, 0607T, 0608T, 0596T, 0597T, 0603T, 0604T, 0613T,33741, 33745, 33746, 93241,93242,93243,93244,93245,93246,93247,93248, 92517, 92518, 92519, 92650, V2524, 33990, 33995
Those and other provider documents can be found under Provider Documents.
Please reach out to the Prior Authorization Department with questions at 1-855-839-1032 or email email@example.com with questions.