For Preferred Specialists
Most services performed by a Preferred Specialist in the office setting can be reimbursed without obtaining Prior Authorization.
The following office-based services do not require prior authorization. If you plan to offer a service not found on this list you will need to submit a Prior Authorization request to HCP for review.
Services not requiring Prior Authorization for Preferred Specialists
Specialty Care Services Requiring Prior Authorization: Non-HCP Preferred Specialist
Prior Authorization must be obtained in advance by the PCP for all services performed by a Non-HCP Preferred Specialist unless delivered during a medical emergency.