Webapps.driscollhealthplan.com

webapps.driscollhealthplan.com

WEBhcpcs/cpt4 codes description covered benefits non covered benefits prior authorization effective date; 0604t. envolve . pr remote oct retina 1st dev set-up & pt educaj

Actived: 5 days ago

URL: https://webapps.driscollhealthplan.com/priorauthcheck/Home/IndexIFrame?s=Ophthalmology%2FVision

webapps.driscollhealthplan.com

WEBOUT-OF-NETWORK PROVIDERS. An authorization is required for all services performed by a non-participating provider with the following exceptions:

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Driscoll Health Plan

WEBFor Member assistance, please call: DHP Member Services Ph: 1-877-324-7543 toll-free For Provider assistance, please call: DHP Utilization Management Ph: 1-877-455-1053 …

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Driscoll Health Plan Medical Necessity Guideline

WEBDriscoll Health Plan Medical Necessity Guideline Medical Necessity Guideline: STAR, CHIP, STAR Kids Confidential: For use only by employees and authorized agents of …

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OUT-OF-NETWORK PROVIDERS

WEBhcpcs/cpt4 codes description covered benefits non covered benefits prior authorization effective date; 15630. authorization required. pr delay/sectn flap lid,nos,ear,lip

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OUT-OF-NETWORK PROVIDERS

WEBhcpcs/cpt4 codes description covered benefits non covered benefits prior authorization effective date; 92522. authorization required. pr evaluation of speech sound production …

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Driscoll Health Plan Medical Necessity Guideline

WEBDriscoll Health Plan Medical Necessity Guideline Medical Necessity Guideline: STAR, CHIP, STAR Kids Confidential: For use only by employees and …

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Clinical Information and Documents To Support Medical …

WEBClinical Information and Documents To Support Medical Necessity Page 1 of 21 09/20/2023 Driscoll Health Plan (DHP) may request any combination from the following list of …

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Dental Managed Care Covered Services

WEBfollowing medical checkup codes 99381, 99382, 99391, or 99392. This service is limited to six (6) services per lifetime by any provider. DHP is responsible for paying for treatment …

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Driscoll Health Plan Inpatient and Observation Admission …

WEBPage 3 of 2 Driscoll Health Plan Inpatient and Observation Admission Authorization Requirements • Via telephone call to the DHP UM department, toll free 1-877-455-1053.

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