Spine Centers of Excellence

The Priority Health Spine Centers of Excellence (COE) help ensure that all patients with persistent neck and back pain or other spine-related problems receive a timely, comprehensive, non-surgical medical evaluation. This evaluation is required before surgical evaluation for Priority Health patients.

Physiatrist-led multi-disciplinary Spine COE clinics offer patients the best and most appropriate care. Physiatrists are physicians who are trained to diagnose and manage musculoskeletal problems, including spine- or back-related problems.

Through the Spine Centers of Excellence, patients receive:

• An evaluation within 2 working days
• In–person acute case reviews within 10 business days
• Treatment that usually does not require surgery.

Referrals

Physicians can refer members to a Priority Health Spine COE at any point in the treatment process without prior authorization, including before or after failure of conservative care. Referrals to surgeons, however, do require prior authorization and plan approval.

• Spine Centers of Excellence Referral form (83KB PDF) - This optional form is for use by the PCP when referring to a physiatrist. It should not be sent to Priority Health.
• Surgical Prior Authorization form (257KB PDF) – This form is required when referring a patient to surgery.

More details:

• The referral process
• Shared decision-making
• Reimbursement for initial evaluation at a Spine Center of Excellence
  
• Forms and tools (this link takes you to the Clinical Resources section of this website)
  
• Spine Centers of Excellence medical policy (68KB PDF)
• List of Centers and contact information
  
• Clinical Practice Guideline: Diagnosis and management of low back pain (this link takes you to the Clinical Resources section of this website)
  
• FAQs for PCPs
  
• FAQs for Surgeons
• FAQs for Centers

You'll need Adobe® Reader Software to view and print PDF files. Download it free now!