We returned to the normal process for:
- Preauthorization approvals*
- Home health care services
- Long-term acute care hospitals (LTACH) and acute rehabilitation
- Passage primary care provider (PCP) referrals
These updates cover ConnectiCare network providers caring for members of both commercial and Medicare Advantage plans, unless noted otherwise. These do not apply to ConnectiCare plans in Massachusetts.
Extensions of previously approved preauthorization requests
Beginning July 1, we will no longer extend previously approved preauthorization requests by 90 days. Approvals that have been extended before July 1 are not affected.
This applies to:
- Inpatient elective admission requests
- Outpatient procedures/requests
- Out-of-network requests
- Infertility services (commercial plans only)
- Durable medical equipment
Please note, any service or surgery canceled without a reschedule date or rescheduled outside of the authorization date range will require a new preauthorization from ConnectiCare as of July 1.
You can submit preauthorization requests by:
|
Commercial patients |
Medicare Advantage patients |
---|
Fax: |
860-674-5893 (preauthorization)
860-409-2437 (home care) |
866-706-6929 (preauthorization)
860-678-5291 (home care) |
Phone: |
800-562-6833 extension 8552 |
800-508-6157 extension 8553 |
Home health care services and requests
Also after July 1, ConnectiCare will review and approve initial and re-authorization requests for home health care services for date spans that meet the need for the services. This applies to the following requests:
- Physical therapy
- Occupational therapy
- Speech therapy
- Medical social worker
- Home health aide
- Skilled nursing visit
- IV therapy
Hospital discharges to LTACHs and acute rehabilitation facilities again require preauthorization
Discharges of ConnectiCare members from hospitals to LTACHs or acute rehabilitation facilities after July 1 will need preauthorization before the date of discharge. Please submit preauthorization requests to us or our partner, CareCentrix, as noted in the chart below:
Admission to: |
ConnectiCare |
CareCentrix |
---|
LTACHs |
860-678-5282 (Fax)
800.508.6157 (Phone) |
N/A |
Acute rehabilitation |
N/A |
866-501-4665 (Fax)
844-359-5388 (Phone) |
*Preauthorization approval is not a guarantee of coverage. Coverage is dependent on member eligibility at the time service is rendered and the member has not exceeded benefit maximums under his/her plan. Any services rendered over the benefit maximums for a member’s plan year will fall under the member’s financial responsibility.
(12.09.2020)