Preauthorization determination is required for all non-emergency ambulance transports


Preauthorization for all non-emergency transportation has been required for all commercial and Medicare Advantage members since Jan. 1, 2020. Please refer to the preauthorization lists included in this December 2019 provider headline.

Contracted ambulance service providers must make sure ConnectiCare has authorized the non-emergency transport before it happens. Full clinical details must be submitted with all preauthorization requests for routine non-emergency ambulance/medical transport services for all ConnectiCare members. If requests are received after the service is provided, or the service happens before our determination, the claim will be administratively denied for failing to meet the plan’s requirements to obtain preauthorization before the service is rendered.

We encourage preauthorization requests be submitted before scheduling the transport. Please refer to the following policies about non-emergent transportation:

Ambulance service providers should encourage facilities and/or providers to request these services of ConnectiCare directly and then, if approved, share authorization number with the servicing providers.