OrthoNet, LLC reviews preauthorization requests for EmblemHealth’s Spine Surgery and Pain Management Therapies Program for select spine surgery and interventional pain management therapy procedures.
This chapter covers:
- Service locations
- Program inclusions and exclusions
- ICD-10 Procedure/Diagnosis codes
- Preauthorization requirements and process
- Appeal process
A preauthorization does not guarantee payment for services. Payment of claims is dependent on eligibility, covered benefits, provider contracts, and correct coding and billing practices.