Exception Notice
As you know, FamilyCare has made significant strides in implementing new policies and procedures designed to improve the service we deliver to your practice. These changes have resulted in a steady improvement in the timeliness and accuracy of our claims payments and a sustained referral/authorization turn-around time of four hours or less.
In keeping with our efforts to streamline processes, effective August 1, 2011, we will be instituting a set list of services that will not require prior authorization for our Medicaid (OHP) members. This “no-auth” list was designed to help our providers expedite patient treatment. If the CPT or HCPC code appears on this list, it will not require a prior authorization from FamilyCare. Conversely, any service with a CPT or HCPC code not appearing on this list will require prior authorization from FamilyCare in order to receive payment for the service rendered. This policy applies only to Medicaid. To view the "no auths" list, click here.
We will review the “no-auth” list periodically to assess for codes we feel should be added. If you identify codes you would like FamilyCare to consider for addition to the list, please contact Network Services at (800) 335-3205 or email networkservices@familycareinc.org.
This change is designed to improve the quality of care we deliver to our members and the level of service we deliver to our providers. We appreciate your continued support and thank you for the invaluable work you do with our members.
As always, please feel free to contact Customer Service at 800-458-9518 or 503-222-2880 with any questions or concerns you may have.
May 01, 2012 - List of Services Not Requiring Authorization
October 5, 2011 - List of Mental Health Services Not Requiring Authorization