When a service requires a Prior Authorization (PA) per our Behavioral Health\/Medical Policies, it is the responsibility of all those involved in providing the service to verify that PA has been obtained. Not obtaining or verifying a PA on these services can result in denial of payment. This applies to all those rendering services or procedures requiring a PA, including Ambulatory Surgery Centers, hospitals, and even physicians and diagnostic radiologists who are interpreting images.*<\/p>\n
To learn more about the procedures requiring authorizations, please reference our medical policies at healthnewengland.org\/Providers\/Resources.<\/a> For more information, please call your Provider Relations Representative at (800) 842-4464 ext. 5000, or by sending an email to providerrelations@hne.com<\/a>.<\/p>\n *Readers who interpret results from High Cost Imaging diagnostics (MRI, PET, CT and Nuclear Cardiology) are also required to follow Prior Authorization Requirements. If there was no request for Prior Authorization or if the request was denied, there will be no payment to the reader.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":" When a service requires a Prior Authorization (PA) per our Behavioral Health\/Medical Policies, it is the responsibility of all those involved in providing the service to verify that PA has been obtained. Not obtaining or verifying a PA on these services can result in denial of payment. This applies to all those rendering services or […]<\/p>\n","protected":false},"author":1,"featured_media":1740,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[92],"tags":[],"class_list":["post-6592","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-provider-newsletter"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"https:\/\/i0.wp.com\/hnetalk.com\/provider\/wp-content\/uploads\/2015\/08\/medical-billing-web.jpg?fit=700%2C431","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p6ZZHB-1Ik","_links":{"self":[{"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/posts\/6592","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/comments?post=6592"}],"version-history":[{"count":1,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/posts\/6592\/revisions"}],"predecessor-version":[{"id":6593,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/posts\/6592\/revisions\/6593"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/media\/1740"}],"wp:attachment":[{"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/media?parent=6592"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/categories?post=6592"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/tags?post=6592"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}