authorization for selected services is available by telephone when the request
is initiated by a provider authorized to request prior authorization as listed
in section 10 of this rule. A prior authorization request form is not necessary
for these selected services. Additional written substantiation and
documentation may be required by the office. Notification of approval or denial
will be given at the time the telephone call is made for the following:
(1) Inpatient hospital admission and
concurrent review, when required under this rule.
(2) Continuation of emergency treatment for
those conditions listed in section 13 of this rule on an inpatient basis
originally without prior authorization subject to retrospective medical
Prior authorization may be obtained by telephone provided a properly completed
prior authorization request form is subsequently submitted for the following:
(1) Medically necessary services or supplies
to facilitate discharge from or prevent admission to a general
(2) Equipment repairs
necessary for life support or safe mobility of the patient.
(3) Services when a delay of beginning the
services could reasonably be expected to result in a serious deterioration of
the patient's medical condition.