Services Requiring No Authorization - Prestige health choice

Prestige Health Choice has determined that many routine inoffice procedures and diagnostic tests may be performed without medical review to facilitate timely and effective treatment of members.

Certain diagnostic tests and procedures that are considered by Prestige Health Choice to be routinely part of an office visit, such as sigmoidoscopy, EKG and plain film x-rays (see Benefit
grid - posted on web site).).

Any services performed by a County Health Department (CHD), a migrant health center or a community health center for the following:

• Diagnosis and treatment of sexually transmitted diseases and other communicable diseases, such as tuberculosis and human immunodeficiency syndrome;

• Provision of immunizations;

• Family planning and related pharmaceuticals;

• School health services listed above and for services rendered on an urgent basis by such providers; and,

• In the even that a vaccine-preventable disease emergency is declared, any claim from the CHD for the cost of administering the vaccines

No comments:

Medical Billing Popular Articles