| J.16-J.24 |
Utilization Reviews and Quality Improvement Activities FY-11 & FY-12 |
|---|---|
| J.16 [PDF] |
Utilization Reviews and Quality Improvement Activities FY-11 & FY-12 |
|
J.17 |
Department of Health Care Finance Utilization Services Policies and Procedures |
| J.17.1 [PDF] |
Office of Utilization Management Prior Authorization Dental Services |
| J.17.2 [PDF] |
Office of Utilization Management Prior Authorization for Selected Outpatient Surgeries |
| J.17.3 [PDF] |
Office of Chronic & Long-Term Care Prior Authorization of Extended Personal Care Aide (PCA) Services |
| J.17.4 [PDF] |
Office of Quality Management of Program Integrity Authorization Process for Non-Cosmetic Botox Injections |
| J.17.5 [PDF] |
Out of State Nursing Home Placement |
| J.17.6 [PDF] |
Office of Quality Management/Program Integrity Prior Authorization Process for Gastric By-Pass Surgery |
| J.17.7 [PDF] |
Office of Disabilities and Aging Prior Authorization Process for the Elderly and Individuals with Physical Disabilities (EPD) Waiver |
| J.17.8 [PDF] |
Prior Authorization Process for Durable Medical Equipment, Prosthetics, Orthotics and Supplies Revised |
| J.17.9 [PDF] |
Office of Utilization Management Prior Authorization Eyewear and Contact Lenses |
| J.18 [PDF] | Sample completed 719A Form |
| J.19 [PDF] | Instructions to complete 719A Form |
| J.20 [PDF] | Ineligible Recipient Program Code |
| J.21 [PDF] | Prior Authorization Subsystem Details |
| J.22 [PDF] | Acute Care and Specialty Hospital Facility List |
| J.23 [PDF] | Long Term Care Facility List |
| J.24 [PDF] | Health Insurance Portability and Accountability Act (HIPPA) |