Fraud, Waste and Abuse violations related to COVID-19
The Office of Inspector General (OIG) will be auditing provider fraud, waste and abuse related to COVID-19. Misinterpretation, not just intentional fraud, could lead to
Provider Resources
Overview of Referrals and Prior Authorizations
Specialist Referral Process
Referral Process Tool
HCP Preferred Specialists and Centers of Excellence
Prior Authorization Process
Prior Authorization Process Tool
Submit a Prior Authorization Request
Prior Authorization – Hospital & Facility-Based Services
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Prior Authorization – Injectable Medications
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Prior Authorization – Physical and Occupational Therapy
View an Existing Prior Authorization Request
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Identifying HCP Direct Patients
