Home health prior auth changes coming Jan. 1, 2020
Beginning Jan. 1, 2020, all home health visits for members with commercial group and individual plans will require prior authorization before the first visit. Historically, these visits did not require authorization for the first 30 home health visits per plan year.
Medicare and Medicaid plans already require authorization before the first visit.
How do I request prior authorization?
In-network providers can request authorization for home health services by logging into priorityhealth.com/provider and clicking "Request an authorization". Our online tool lets you quickly and easily submit your request and see the medical necessity criteria.
If you do not already have a provider login for priorityhealth.com, register for one here. It can take up to 48 hours to have an account created, so we encourage you to sign up today.
Can I fax a request form?
The fax request form is for out-of-network home care agencies only.
We're here to help
If you have questions, contact the Provider Helpline at 800.942.4765.