Preauthorization requests for hip, knee and shoulder arthroscopy procedures can be submitted to OrthoNet online, by phone or by fax.
Submit a request online
The easiest way to submit a preauthorization request for arthroscopy is by by using OrthoNet’s online portal. The secure web portal provides physicians and other health care professionals with the capability to submit authorization requests and check their status, as well as reprint copies of authorization letters.
To register for web portal access, visit www.orthonet-online.com. Choose “Provider,” and then select “Humana” in the “Health Plan Contracts” box. Finally, choose “New User-Account Request Form” and submit your information.
Submit a request by phone
To initiate a preauthorization request for arthroscopy via telephone, you may call OrthoNet at 1-866-565-4733, from 8:30 a.m. to 5:30 p.m. Eastern time, Monday through Friday.
Submit a request via fax
You can also fax authorization requests directly to OrthoNet at 1-866-621-9008. Request forms are available on OrthoNet’s website. Fax a completed request form and the supporting clinical information listed below.
For patients in Puerto Rico
- For Puerto Rico patients with commercial coverage, submit preauthorization requests by telephone at 1-800-611-1474, or by fax to 1-800-658-9457.
- For Puerto Rico patients with MA coverage, submit preauthorization requests by telephone at 1-866-488-5995 or 1-866-773-5959, or by fax to 1-800-594-5309.
As you move through the preauthorization process, you will be prompted to provide the following clinical information, along with the name and identification number of the patient and the physician:
- Patient diagnosis
- Clinical information relevant to the procedure, such as:
- Significant clinical history, including history of present illness, significant comorbidities, current medications, surgical history, key clinical exam findings and the results of conservative therapy
- Relevant current imaging reports and other key diagnostic test results
Following OrthoNet’s review of the submitted information, you will be given an authorization number, or you will be asked for additional information if the request is incomplete or does not meet evidence-based criteria for arthroscopy.
If OrthoNet requests medical records as a result of your preauthorization request, please return the information promptly to facilitate the timely processing of your request.