Health Alliance Prior Authorization List

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Prior Authorization & Clinical Review Criteria - Health Alliance

(5 days ago) WEBPrior Authorization (PA) Lists* 2021 DME List Standard (1/1/2021-12/31/2021) 2022 DME List Standard (1/1/2022-12/31/2022) 2023 DME List Standard Health Alliance uses medical necessity criteria based on published clinical evidence to make utilization and …

https://www.healthalliance.org/clinical-review-criteria

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Prior Authorization List—Standard Effective January 1, 2024

(7 days ago) WEB****Chemotherapy initiated while the member is in an inpatient facility does not require prior authorization. PHUMHA24-PAListStandard-0923 Y0034_24_114877_C Updated …

https://www.healthalliance.org/media/services/default.pdf

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Medications Requiring Preauthorization - Health Alliance

(1 days ago) WEBmust request preauthorization from Health Alliance Medicare forgs dru on this list. This list is subject to change. To request a written copy of the coverage criteria, please contact …

https://healthalliance.org/documents/1312

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Preauthorization List—Standard Effective January 1, 2023

(1 days ago) WEBBreast implant surgeries. Gynecomastia surgery. Reduction mammoplasty, female. Cardiac imaging and procedures (echo, echo stress, cardiac rhythm implantable devices, …

https://www.healthalliance.org/documents/24063/2023

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Preauthorization Overview - Health Alliance

(5 days ago) WEBTo get started with the AOD process, go to the Request Preauthorization tab. From the options to request a preauthorization with Health Alliance, choose the File Medical …

https://www.healthalliance.org/media/Resources/pnm-preauthbklt-0518-WEB.pdf

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FLASH: Health Alliance Prior Authorization Changes for 2024

(9 days ago) WEBEach year, Health AllianceTM performs a comprehensive review and analysis around services needing prior authorization. In our last review cycle, we removed prior …

https://provider.healthalliance.org/informed-post/flash-health-alliance-prior-authorization-changes-for-2024/

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FLASH: Request Preauthorization Online - Providers :Providers

(2 days ago) WEBOur online submission tools allow you to track and receive notifications about your preauthorization requests. They also help us process requests more quickly. …

https://provider.healthalliance.org/informed-post/request-preauthorization-online/

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How do I check the status of my prior authorization - Health …

(6 days ago) WEBHow do I check the status of my prior authorization and claim request? Log into your member account on Hally.com or the MyChart mobile app. Once logged in, you …

https://help.healthalliance.org/help/how-do-i-check-the-status-of-my-prior-authorization-and-claim-request

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Pharmacy/Medical Drug Prior Authorization Form - Health …

(4 days ago) WEBProviders are strongly encouraged to submit this form and all chart documentation via the Health Alliance Pharmacy Provider Portal. This will result in more reliable …

https://www.healthalliance.org/documents/124

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FLASH: Prior Authorization Changes - Providers :Providers

(4 days ago) WEBFLASH: Prior Authorization Changes. July 26, 2022. Reminder: Removal of Prior Authorization for Ultrasound Imaging Tests. Health Alliance™ performs an …

https://provider.healthalliance.org/informed-post/flash-prior-authorization-changes/

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(List of Covered Drugs) - Health Alliance

(7 days ago) WEBHealth Alliance Medicare . 2024 Formulary (List of Covered Drugs) PLEASE READ: THIS DOCUMENT CONTAINS INFORMATION ABOUT THE DRUGS WE COVER IN THIS …

https://portal.healthalliance.org/documents/formulary/668

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Prior Authorization Submission Process - Alliance Health

(1 days ago) WEBFor faster, self-service submit prior authorization requests using the ACS Provider Portal for online admission, concurrent review, and discharge prior authorization. The portal …

https://www.alliancehealthplan.org/providers/tp/submission-processes/pa-submission-process/

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Illinois Uniform Electronic Prior Authorization - Health Alliance

(3 days ago) WEB215 ILCS 5/364.3 requires the use of a uniform electronic prior authorization form when a policy, certificate or contract requires prior authorization for prescription drug benefits. …

https://portal.healthalliance.org/documents/3070/2022

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Health Alliance Standard Large Group and Self-Funded …

(2 days ago) WEBPA Prior Authorization – Your doctor is required to provide additional information to determine coverage. PV Preventive – These medications are covered at $0 under …

https://portal.healthalliance.org/documents/formulary/663/2022

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Horizon Blue Cross Blue Shield of New Jersey - MyPrime

(Just Now) WEBAn Independent Licensee of the Blue Cross and Blue Shield Association. If you need help understanding this Horizon Blue Cross Blue Shield of New Jersey information, you have …

https://www.myprime.com/content/dam/prime/memberportal/forms/2019/FullyQualified/Other/ALL/HBCBSNJ/COMMERCIAL/ALL/NJ_Specialty_Drug_List.pdf

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Horizon Advantage Direct Access - eHealth

(6 days ago) WEBPrior Authorization Some services/procedures require prior authorization. For a complete list, call our Customer Service department at 1-800-355-BLUE (2583) or refer …

https://www.ehealthinsurance.com/ehealthinsurance/benefits/sbg/NJ/NJHorizon_ADV_DA_100_80_60.pdf

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(List of Covered Drugs) - Health Alliance

(2 days ago) WEBHealth Alliance Medicare . 2023 Formulary (List of Covered Drugs) PLEASE READ: THIS DOCUMENT CONTAINS INFORMATION ABOUT THE DRUGS WE COVER IN THIS …

https://portal.healthalliance.org/documents/formulary/668/2023

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Authorizations - CHOC Health Alliance

(6 days ago) WEBPrior authorization. Services that require prior approval by CHA before those services are rendered. If approved, the authorization stays active for a specified date range and …

https://chochealthalliance.com/providers/authorizations/

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Horizon Blue Cross Blue Shield of New Jersey 2018 Managed …

(5 days ago) WEBHorizon Blue Cross Blue Shield of New Jersey 2018 Managed Care Benefits-at-a-Glance1. If you have questions about enrollment, benefits or claims, visit NaviNet.net or call 1-800 …

https://www.horizonblue.com/sites/default/files/2018-01/Benefit_Grid_MC.pdf

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Provider Portal and Authorizations – South Country Health Alliance

(4 days ago) WEBUse the Provider Portal for claim dates of service starting January 1, 2019. For dates of service prior to January 1, 2019, or any other issues or questions when using our …

https://mnscha.org/providers/provider-portal-and-authorizations/

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Evernorth Behavioral Health Authorization and Billing …

(6 days ago) WEBor other qualified health care professional, both face-to-face time with the patient and time interpreting test results and preparing the report, first hour. on Facility Contract. Add-on …

https://static.cigna.com/assets/chcp/pdf/resourceLibrary/behavioral/authorization-and-billing-resource.pdf

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