November 15, 2018
Beginning January 1, 2019, outpatient rehabilitation services for Microsoft patients will no longer require prior authorization for physical therapy and occupational therapy through eviCore healthcare. However, Microsoft patients will still need to have a medical treatment plan on file and progress will need to be documented to continue physical and occupational therapy treatments. These services are limited to medical necessity and are subject to medical review upon receipt of claims.
Because services for Microsoft members that are received in 2018 will continue to be reviewed by eviCore, you’ll want to check our prior authorization tool to see if a member needs eviCore healthcare review. The tool instructs you to use eviCore healthcare only when a service requires review.
As a reminder, member eligibility and benefits can change monthly so verification is recommended prior to providing any services.