The Medical Management department at Samaritan Health Plans has implemented new software to manage authorization requests. The new system went into effect June 15 and allows for more accurate and quicker determinations.
Please review the following updates:
1. Changes to the Provider Connect Portal:
a) Prior Authorization (PA) Wizard has been updated to include additional request types and treatment categories. The Wizard will include directions on each page explaining how to use the new features.
b) An expedited attestation has been added to align with CMS regulations. By attesting, a clinician is stating that a loss of life or limb will occur if the request is not processed in the 72-hour timeframe. *Do not use expedited authorizations for any other reason as it may result in additional delays.
2. Submission of Authorizations:
- To reduce the burden of unneeded submissions, make sure to review the authorization list for the specific plan to ensure the service being provided requires an authorization.
- Authorizations can be requested and tracked electronically through the PA Wizard in Provider Connect. By utilizing this service, you have an electronic record of each authorization. You are urged to submit electronically rather than using faxes, when possible.
For additional information on submitting authorizations through Provider Connect, call the PA Wizard helpline at: 541-768-4409.