Services Requiring Prior Authorization. All Covered Services not provided by the Member's Primary Care Provider (PCP) require Prior Authorization from the PCP and HPN’s Managed Care Program. The following Covered Services require Prior Authorization and review through HPN’s Managed Care Program: Non-emergency Inpatient admissions and extensions of stay in a Hospital, Skilled Nursing Facility, Residential Treatment Center or Hospice. Outpatient surgery provided in any setting, including technical and professional services.
Appears in 4 contracts
Sources: Agreement of Coverage, Agreement of Coverage, Agreement of Coverage
Services Requiring Prior Authorization. All Covered Services not provided by the Member's Primary Care Provider Physician (PCP) require Prior Authorization from the PCP and HPN’s Managed Care Program. The following Covered Services require Prior Authorization and review through HPN’s Managed Care Program: • Non-emergency Inpatient admissions and extensions of stay in a Hospital, Skilled Nursing Facility, Residential Treatment Center or Hospice. • Outpatient surgery provided in any setting, including technical and professional services. • Diagnostic and Therapeutic Services.
Appears in 1 contract
Sources: Group Enrollment Agreement
Services Requiring Prior Authorization. All Covered Services not provided by the Member's Primary Care Provider Physician (PCP) require Prior Authorization from the PCP and HPN’s Managed Care Program. The following Covered Services require Prior Authorization and review through HPN’s Managed Care Program: Non-emergency Inpatient admissions and extensions of stay in a Hospital, Skilled Nursing Facility, Residential Treatment Center or Hospice. Outpatient surgery provided in any setting, including technical and professional services.
Appears in 1 contract
Sources: Agreement of Coverage