Common use of Prior Auth Required Clause in Contracts

Prior Auth Required. Hyperbaric Oxygen Therapy is a covered benefit only if the therapy is proposed for a condition recognized as one of the accepted indications as defined by the Hyperbaric Oxygen Therapy Committee of The Undersea and Hyperbaric Medical Society (UHMS). Hyperbaric Oxygen Therapy is Excluded for any other condition. Hyperbaric Oxygen Therapy requires Prior Authorization and services must be provided by your In-network Practitioner/Provider in order to be Covered.  Mental Health Services and Alcoholism and Substance Abuse Services  Mental Health Services  Some mental health services require Prior Authorization. The In-network Behavioral Health Practitioners/Providers will be responsible for obtaining Prior Authorization, when required. For Out-of-network Services, Members need to contact our Behavioral Health Department to obtain Prior Authorization, when required. Please refer to the Prior Authorization Section for services that require Prior Authorization. For assistance or for questions related to mental health services, you may call our Behavioral Health Department directly at (▇▇▇) ▇▇▇-▇▇▇▇ or toll-free at ▇-▇▇▇-▇▇▇-▇▇▇▇. o Partial Hospitalization can be substituted for the Inpatient mental health services when our Behavioral Health Department approves the Prior Authorization request. Partial Hospitalization is a non-residential, Hospital-based day program that includes various daily and weekly therapies. o Acute medical detoxification benefits are Covered under Inpatient and Outpatient Medical services found in the Benefits Section. All services require Prior Authorization.

Prior Auth Required. Hyperbaric Oxygen Therapy is Is a covered benefit only if the therapy is proposed for a condition recognized as one of the accepted indications as defined by the Hyperbaric Oxygen Therapy Committee of The Undersea and Hyperbaric Medical Society (UHMS). Hyperbaric Oxygen Therapy is Excluded for any other condition. Hyperbaric Oxygen Therapy requires Prior Authorization and services must be when provided by your an In-network Practitioner/Provider in order to be Covered.  Infertility Treatment Infertility Trea ment Diagnosis and medically indicated treatments for physical conditions causing infertility.  Mental Health Services and Alcoholism and Substance Abuse Services  Mental Health Services  Some mental health services require Prior Authorization. The In-network Behavioral Health Practitioners/Providers will be responsible for obtaining Prior Authorization, when required. For Out-of-network Services, Members need to contact our Behavioral Health Department to obtain Prior Authorization, when required. Please refer to the Prior Authorization Section for services that require Prior Authorization. For assistance or for questions related to mental health services, you may call our Behavioral Health Department directly at (▇▇▇) ▇▇▇-▇▇▇▇ or toll-free at ▇-▇▇▇-▇▇▇-▇▇▇▇. o Partial Hospitalization can be substituted for the Inpatient mental health services when our Behavioral Health Department approves the Prior Authorization request. Partial Hospitalization is a non-residential, Hospital-based day program that includes various daily and weekly therapies. o Acute medical detoxification benefits are Covered under Inpatient and Outpatient Medical services found in the Benefits Section. All services require Prior Authorization.Benefits