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Getting a referral processed while switching Medicaid plan?



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amother
OP


 

Post Sun, Jul 07 2019, 4:10 pm
Going to be switching from united healthcare to health first (NY Medicaid plan). We just had an appt that requires prior authorization moved up to early August.
Anyone knows if this can still work? Going to try contacting Medicaid tomorrow, but I know sometimes getting thru to them is no picnic- so wondering if anyone has experience with this.
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amother
Seafoam


 

Post Sun, Jul 07 2019, 4:19 pm
Generally prior authorization is required by the plan itself, not by Medicaid. Until you have an ID with the new plan, they most likely can't submit the request. In my experience the person needs to be active on the plan in order for them to locate you/ your ID. Ask the PCP office if it will be possible to expedite the prior authorization once you're active on the plan so you have it in time for the appointment.
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pesek zman




 
 
    
 

Post Sun, Jul 07 2019, 5:32 pm
If the switch will be effective 8/1, for an appt that week or so, I believe healthfirst is one of the few policies that do permit pre-auth to be obtained even before the plan is active.
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amother
OP


 

Post Sun, Jul 07 2019, 7:07 pm
L
pesek zman wrote:
If the switch will be effective 8/1, for an appt that week or so, I believe healthfirst is one of the few policies that do permit pre-auth to be obtained even before the plan is active.

Thanks, that would be awesome. Last time UHC gave us hell getting this appt approved. It was a nightmare. One of the reasons we’re switching to healthfirst. Meanwhile the hospital moved us up over a month leaving us in a quandary.
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