Apple Health: Update for Submitting Prior Authorization Requests for Extractions
Washington State Health Care Authority sent this bulletin at 01/31/2017 12:55 PM PST
Apple Health (Medicaid): Provider Alert
This alert is an update to a provider alert issued on
January 12, 2017. This update is necessary to clarify the effective date of the
change.
Update
for Submitting Prior Authorization Requests for Extractions
In order to correctly process prior authorization (PA)
requests for extractions, providers must list the appropriate CDT code along
with the tooth/teeth number(s) on the General
Information for Authorization form (HCA 13-835). Add this information to
each individual line for each individual tooth number (boxes 20-26) on the HCA
13-835 form, or add it to box 30 of the HCA 13-835 form.
Effective
for prior authorization requests received on and after February 1, 2017,
the Health Care Authority (agency) will reject all PA requests for extractions
that do not indicate the tooth/teeth number(s) on the HCA 13-835 form. The
rejected PA requests must be corrected and resubmitted to agency.
Please do
not reply directly to this message. If you have feedback
or questions, please visit the HCA
website for contact information.
About
WashingtonStateHealth Care Authority HCA oversees the state’s top
two health care purchasers — Washington Apple Health (Medicaid) and the Public
Employee Benefits Board Program. We work with partners to help ensure
Washingtonians have access to better health and better care at a lower cost. For
more information, visit www.hca.wa.gov.