Negative pressure wound therapy
Preauthorization of negative pressure wound therapy (NPWT) is required for patients with commercial (including Humana individual), Medicaid and Medicare Advantage (MA) health maintenance organization (HMO) and preferred provider organization (PPO) coverage.
The terms prior authorization, precertification, preadmission and preauthorization are all used to refer to the preauthorization process. For MA private fee-for-service (PFFS) plans, notification is requested, not required. Notification is requested for these plans so we may help coordinate care for your patients.
Humana does not review preauthorization requests for the following, as physicians who participate in an independent practice association (IPA) or other risk network with delegated services need to refer to their IPA or risk network for guidance:
- Patients treated by Chicago risk and delegated physicians
- Florida MA HMO and Medicaid HMO plans
- Health Care Partners commercial and MA HMO plans