PT/OT/ST Prior Authorization Update

Date: 10/15/18

NH Healthy Families would like to notify Physical Therapy, Occupational Therapy and Speech Therapy providers of a new process that has been implemented for obtaining prior authorization approval for patients approaching the 80 unit CAP limit.

We understand that due to the timing of when claims are submitted and processed in our system, there has been a difference between the number of units displayed in our system and the number of units used per the practice records.

Effective immediately, if a practice indicates that a patient is approaching their CAP limit, our prior authorization team will review the request for medical necessity, regardless of the number of units displayed in our system.

To read the full update, click here (PDF)