Prior Authorization for Therapy Services Update

This alert provides clarification to the May 2012 Florida Medicaid Health Care Alert regarding therapy service prior authorization requirements for recipients with third party liability (TPL).

Reimbursement for therapy services requires prior-authorization from eQHealth Solutions and a prior authorization number (PA#). This includes any Medicaid eligible recipient with TPL coverage. Claims submitted for therapy services where Medicaid is the secondary payor will be denied if a PA# is not included on the claim.

In order to receive reimbursement for services provided prior to June 1, 2012, for recipients with TPL coverage (for whom authorization was not requested) please submit a PA request through eQSuite, following the instructions provided by eQHealth Solutions on their website or call their customer service line at (855) 444-3747.


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