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COVID-19 Preauthorization Updates for Providers

COVID-19 Preauthorization Updates for Providers

RMHP is working to help our communities access health care to the fullest extent possible as we come together to address this national emergency. We’re adopting measures that will reduce administrative burden for providers and facilities, helping members more easily access the care they need under their benefit plan, and adjusting programs and services, as needed, to protect members and help limit the spread of the COVID-19 virus in communities.

As the COVID-19 situation evolves, we may temporarily suspend or relax additional policies as needed. Please continue to watch for additional updates as new information is made available.

­­­­Last update: April 7, 2020, 10:00 a.m. MST


Preauthorization

Effective March 27, 2020, preauthorization requirements for Respiratory-Related Durable Medical Equipment and for facility transfers to Acute Care facilities, Skilled Nursing Facilities (SNF), Long-term Acute facilities (LTAC) and Acute Inpatient Rehabilitation (AIR) are suspended through May 31, 2020. During this time, facilities are not required to submit a prior authorization for transfers to an Acute Care facility, SNF, LTAC or AIR; however, the admitting provider must notify RMHP within 48 hours of admission.

Consistent with existing policy, all services and treatments must be medically necessary. Inpatient concurrent length of stay review will continue

RMHP is here to help. If you have any questions, please contact us.