Keystone Peer Review Organization (Kepro) (medical review agent and Emergency Medical Assistance Care Plan Certification).MHCP (for the specific services listed in this section below).Submit authorization requests to one of the following review agents, based on the type of service requested: Ěn approved authorization does not guarantee MHCP payment all other MHCP requirements must be met.
NUMBER FILL INS MANUAL
Review the Drug Authorizations section of this manual for requesting drug authorizations (do not send drug authorization requests to the medical review agent).When members have other insurance or Medicare, providers must follow authorization and other rules that apply to the primary insurance.Providers must contact the appropriate managed care organization (MCO) for authorization requirements for members enrolled in managed care.MHCP uses the authorization requirement to safeguard against inappropriate and unnecessary use of health care services governed by state law and federal regulations. Some Minnesota Health Care Programs (MHCP)-covered services require authorization. Authorization Requests and Medicare or Third-Party Liability ( TPL ) Coverage.Services Related to Investigational Drugs.Emergency Medical Assistance Kidney Transplants.Emergency Medical Assistance Care Plan Certification Requests.Early Intensive Developmental and Behavioral Intervention S ervice Requests.
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