Standard prior authorization

Except for an emergency, the services listed in the MCO standardized prior authorization table that do not fall within the presumptive approval parameters, still require prior authorization. Providers must submit a Physician’s Request for Authorization of Medical Services or Recommendation for Additional Conditions for Industrial Injury or Occupational Disease (C-9) to indicate the services they will provide through formal authorization.

Note: Presumptive authorization and standardized prior authorization guidelines do not apply to self-insuring employers’ claims.

Click here to learn more about presumptive authorization.
Click here for more information about requesting authorization.