Services Requiring Pre-authorization

Lawrence Memorial Hospital Services Members, please see services that require pre-authorization for your plan.

Search or browse by service type to see services requiring pre-authorization.

Please also check the QualChoice Coverage Policies if you do not find a specific procedure listed here.

These services require Pre-Authorization.Click to View Medical Policy
Bone Growth Stimulators
Cervical Pneumatic Traction
Cochlear Implants
Contact lenses prescribed for disease other than refractive error. *
Continous Glucose Monitor
Electrical Stimulators for Pain
External Cardioverter-Defibrillators
Extremity compression devices for edema, lymphedema or venous insufficiency.
Home Light Therapy (Home UV Light Treatment)
Insulin Pumps
Orthotic Devices & Services
Prosthetics
TENS Garments
Wearable External Cardioverter/Defibrillator
Wound Vac

QualChoice Network Medical Providers: You will receive verbal approval when requesting pre-authorization. Please inform your patient at that time that the request has been approved. Thank you.

Pre-authorization is the decision to cover a planned medical procedure, prescription drug or medical device. Pre-authorization is not a promise of payment for care or services.

Items with an asterisk (*) may be reviewed after the service has been performed. All others must be approved before services are performed. The member must get pre-authorization for any services outside the network noted on their ID card.

Payment for care or services is based on eligibility, medical necessity and available benefits at time of service and is subject to all contractual exclusions and limitations, including pre-existing conditions if applicable.

Future eligibility cannot be guaranteed and should be rechecked at time of service. Verify benefits by signing into My Account or calling Customer Service at 800.235.7111 or 501.228.7111.

QualChoice follows care guidelines published by MCG Health.

Copyright © 2021 QualChoice® all Rights Reserved.