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Superior HealthPlan PHONE: o Physical Health: 1-800-218 ...
Anesthesia Services: Pain Management: Interventional Pain Mangaement NOTES: For members 18 years of age and older. Contact Texas National Imaging Associates at 1-800-642-7554, or visit Intensive Outpatient Program (IOP) Services (Mental Health/Substance Use …
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Ambetter from Superior HealthPlan
www.superiorhealthplan.com• Ambetter from Superior HealthPlan is an HMO Benefit Plan. • Members enrolled in Ambetter must use in- network participating providers, except in the case of emergency services. • If an out-of-network provider is used (except in the case of emergency services), the member will be 100% responsible for all charges.
CLAIMS APPEAL PAYMENT RECONSIDERATION & DISPUTE …
www.superiorhealthplan.comPlease complete the following form to help expedite the review of your claims appeal. *Is this a. Request for Reconsideration: you disagree with the original claim outcome (payment amount, denial reason, etc.) Please check if this is the first time you are asking for a review of the claim. ... Farmington, Missouri 63640- 3800 . Author: Jill ...
Tamiflu® Treatment and Prophylaxis Information per CDC ...
www.superiorhealthplan.como Prevention of influenza among residents of institutions, such as long-term care facilities, during influenza outbreaks in the institution. For more information, see IDSA Guidelines website. An emphasis on close monitoring and early initiation of antiviral treatment if fever and/or respiratory symptoms develop is an alternative to
Medicare Prior Authorization List Effective January 1, 2021
www.superiorhealthplan.comBreast Reduction Capsule Endoscopy Chondrocyte Implants Cochlear Implant Facial Osteotomy Hysterectomy Joint Replacements Mastectomy for Gynecomastia . Medicare Prior Authorization List . Effective January 1, 2021 . ... J7326 GEL-ONE J7327 MONOVISC INJ PER DOSE J7328 HYAL/DERIV GELSYN-3 IA INJ 0.1 MG ...
Claim Adjustment Reason Codes Crosswalk to EX Codes
www.superiorhealthplan.comClaim Adjustment Reason Codes Crosswalk to EX Codes: SHP_20161447 2 Revised April 2016 EX Code Reason Code (CARC) RARC DESCRIPTION TYPE EXCB 15 N596 AUTHORIZATION IS CANCELLED -ERROR IN ENTRY DENY EXHc 15 . N517 DENY: NO AUTHORIZATION ON FILE THAT MATCHES SERVICE(S) BILLED . DENY EXhf . 15 N596 . DENY: NO …
Ambetter from Superior HealthPlan
www.superiorhealthplan.com• High-Tech Imaging (i.e., CT, MRI, PET) • Infertility • Obstetrical Ultrasound – Two allowed in a nine month period. Any additional ultrasounds will require prior authorization (unless rendered by a Perinatologist). – For urgent/emergent ultrasounds, treat using best clinical judgment and authorizations will be reviewed retrospectively.
Claim Adjustment Reason Codes Crosswalk
www.superiorhealthplan.comex07 7 n517 deny: the procedure code is inconsistent with the patient s sex deny ex09 9 n657 deny: the diagnosis is inconsistent with the patient s age or sex deny ... visit & preven codes are not payable on same dos w o documentation deny ... svc not covered based on age of patient and provider specialty deny
REQUEST FOR PRIOR AUTHORIZATION - Superior HealthPlan
www.superiorhealthplan.comAuthorization Number. Units Dates Authorized. Genetic Testing Type: Pregnant. Yes No. Urgent Request - By checking this box, I certify that this is an urgent request medically necessary treatment, which must be treated within 24 hours.
Wellcare By Allwell
www.superiorhealthplan.comHEDIS/Care gap reviews Financial analysis EHR Utilization Demographic information updates Initiate credentialing of a new practitioner . Confidential and Proprietary Information Membership. Confidential and Proprietary Information ... Supplemental Benefits at a Glance
TX-PAF-5869 - Medicaid Prior Authorization Fax Form
www.superiorhealthplan.comMEDICAID PRIOR AUTHORIZATION FORM Complete and Fax to: 800-690-7030 Behavioral Health Requests/Medical Records: Fax. 866-570-7517. Transplant: Fax. 833-589-1245 . Request for additional units. Existing Authorization. Units. Urgent requests - I certify this request is urgent and medically necessary to treat an injury, illness or condition (not ...
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RADIOLOGY CPT CODE
www.premierradiology.com12. Briarville also provides complimentary evaluation of pain management patients. 13. Our Belle Meade location has an accredited Pain Management and Interventional Radiology Surgery Center. 14. Saturday MRIs are available by appointment at Belle Meade, Brentwood, Clarksville, Cool Springs, Hendersonville, Hermitage, Murfreesboro and Smyrna. 15.
Computer Based Testing (CBT) Assessment Guideline
services.dha.gov.aeAnesthesia Gastroenterology Nephrology Cardiology Dermatology Pulmonary Disease Anatomic Pathology ... Office Evaluation and Management of the Adult Patient, Latest Edition. • Common Psychiatric Problems ... • Interventional • Breast • Nuclear Medicine • Ultrasonography • Contrast and Safety Exam Coverage Return.
MINISTRY OF HEALTH MEDICAL SERVICES COMMISSION …
www2.gov.bc.ca23. RHEUMATOLOGY..... 23-1 Referred Cases .....23-1
2022 MEDICAL STAFF DIRECTORY - Sentara Healthcare
www.sentara.comFrank W. Gordon, MD Sentara Anesthesiology Specialists 2010 Health Campus Drive, Harrisonburg, VA 22801 757-363-6230; Fax: 540-438-5618 Medical School: University of Virginia School of Medicine Internship: University of Virginia Hospitals Residency: University of Virginia Hospitals Board Certification: Anesthesiology Member since 1996