Need Additional Services Authorized? New, Separate Request May Be Required

Thursday, May 13, 2021

Health Net Federal Services, LLC (HNFS) has noticed an increase in authorization change requests from durable medical equipment, prosthetic and orthotic (DMEPOS) providers that actually should have been submitted as new authorizations. While our online Authorization Change Request Form offers a convenient way to request certain changes, such as updating the servicing provider or changing a procedure date, if you need to add services that on their own require HNFS approval, please submit a new request rather than asking to modify an existing authorization. Your cooperation with this guideline helps ensure timely access to care.

Specifically, we are seeing an increase in providers who want to add codes to approved authorizations for CPT® 97760 (orthotic management and training); however, the guideline to submit a new request for any additional services that require prior approval applies to all authorizations.

As specified in our approval letters, if your patient needs additional services that require prior authorization, please submit a separate, new request. Be sure to include supporting documentation for items requested as this will expedite our review.

To learn more about prior authorization requirements, visit our Prior Authorization, Referral and Benefit Tool page.