Authorization Policies for Coventry HMO & PPO
Health Provider Website: http://coventryhealthcare.com/
Accepted Health Plans: HMO
PPO
International
Does the diagnostic service require prior authorization?
MRI: YES*
CT Scans: YES*
PET: YES*
X-rays: NO**
Polysonograms: YES
Ultrasounds: NO
Physical Therapy: NO
Occupational Therapy: NO
Audio Evaluation: YES
Audio Evaluation: YES
Speech Evaluation: NO
Feeding and Swallowing Evaluation: NO
*Authorizations for high-end imaging (MRI, CT, PET Scans) are issued by National Imaging Association (NIA). Please contact 1-800-642-7821 to obtain authorization.
**Authorization requirements are based on procedure code. Please contact the Authorization Unit for verification on whether or not your specific x-ray requires authorization
Lab Information
Preferred Independent Lab: LabCorp
Laboratory testing cannot be administered without the required forms. Please bring the
LabCorp form
(provided by your doctor) to your appointment. Lab Hours of Operation are from 7 a.m. to 3 p.m. Monday through Friday and 7 a.m to 11 a.m. on Saturdays. Labs are closed Sundays. For additional information please call 305-666-6511 ext 1964.
International Policies
International policies require a verification of benefits letter (VOB) from the health plan confiriming eligibility and coverage for the desired services. Please contact your health plan directly in order to verify coverage.
Nicklaus Children's Hospital offers a Global concierge service, in which International patients can experience world renowned and comprehensive service. The Global Department will be able to help facilitate all of your healthcare needs.
For more information, please contact the Global Health Department via e-mal at globalhealth@nicklaushealth.org or by calling 305-662-8281.