Prior Authorization Tips - Removal of PA for Observation, CPAP and BiPAP
Removal of PA for Observation, CPAP and BiPAP:
In attempts to reduce the administrative burden of providers, Magnolia has removed the Prior Authorization requirements for CPAP and BiPAP for ALL providers and for Observation for non-par providers. Magnolia previously removed the Prior Authorization requirement for Observation for par providers in 2016. Magnolia will continue to monitor utilization, and if overutilization is identified, providers may be audited for medical necessity reviews.