Reminder: New authorization requirement for thyroidectomies

Educational video for Thyroid-Related Procedure

Beginning Jan. 1, 2019, prior authorizations for thyroidectomies will be required for Medicare. 

If authorizations are not received, payment may deny. Authorization requests will be submitted automatically through our authorization tool, Clear Coverage®. Clear Coverage gives you fast, easy requests with transparent medical necessity criteria. Request an authorization by logging into priorityhealth.com/provider and clicking “Request an authorization.”

Plan types affected

Commercial and Medicaid: prior authorization was effective Oct. 1, 2018.

Medicare: prior authorization will be required effective Jan. 1, 2019.

Right care, right time

Our goal is to ensure all patients get the right care at the right time. We want to work together with you—our provider partner—to support and enhance work that improves the cost, quality and experience of care while minimizing variation.

By adding prior authorization for select procedures that have significant variation and overutilization compared to national standards, we’re taking initial steps to engaging specialists to become active participants in transforming the care model.

Questions?

See the new Thyroid-Related Procedures information: Authorizations > Medical Policies > Policy Changes list