Allwell from PA Health & Wellness (Medicare)
Please Note: The Authorization Tool will be under maintenance Thursday, July 29 at 6:00 p.m. Central Time to 9:00 p.m. Central Time. Certain functions of the tool may not work properly during this time. We apologize for the inconvenience. Thank you for your patience.
All attempts are made to provide the most current information on the Pre-Auth Needed Tool. However, this does NOT guarantee payment. Payment of claims is dependent on eligibility, covered benefits, provider contracts, correct coding and billing practices. For specific details, please refer to the Medicare Advantage provider manual. If you are uncertain that prior authorization is needed, please submit a request for an accurate response.
Musculoskeletal Services need to be verified by TurningPoint.
Non-participating providers must submit Prior Authorization for all services.
For non-participating providers, Join Our Network
Are services being performed in the Emergency Department or Urgent Care Center, or are the services for dialysis or hospice?
|Types of Services||YES||NO|
|IS THE MEMBER BEING ADMITTED TO AN INPATIENT FACILITY?|
|ARE ANESTHESIA SERVICES BEING RENDERED FOR PAIN MANAGEMENT, DENTAL SURGERY, OR SERVICES IN THE OFFICE RENDERD BY A NON-PARTICIPATING PROVIDER?|
|IS THE MEMBER RECEIVING GENDER REASSIGMENT SERVICES?|
|IS THIS AN HMO OUT OF NETWORK SERVICE REQUEST?|