Preauthorization for cardiac devices is required for all commercial and most Medicare members, unless otherwise noted below. It is also required for Humana Integrated Care Program members (Illinois). For Medicare Advantage (MA) Private Fee-for-Service (PFFS) plans, notification is requested, but it is not required. For administrative-services-only (ASO) groups, authorization is not required; but, if it is requested, HealthHelp will manage services.
Exclusions from the preauthorization requirement include the following:
- Puerto Rico commercial and MA members
- Florida MA health maintenance organization (HMO) and Medicaid HMO members
- Atlanta MA HMO members (primary care physician referral required)
- Ochsner commercial and MA HMO members
- Health Care Partners commercial and MA HMO members
- Chicago risk and delegated providers
Submit a request by phone
Available 7 a.m. to 7 p.m. CST, Monday through Friday, and 9 a.m. to 4 p.m., Saturday.
Submit a request online
Health care providers may submit an online request via HealthHelp’s RadConsult™ online program.