Prior Auth Required

51303 - In accordance with California Civil Code, Section (k), the Alliance cannot reimburse providers for services

This procedure appears on the selected insurer prior authorization source.

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Prior authorizationPrior Auth Required
Procedure / ServiceIn accordance with California Civil Code, Section (k), the Alliance cannot reimburse providers for services
Procedure / Service Description

Debarment, Suspension, Ineligibility of Prescribing Providers - Debarment, Suspension, Ineligibility of Prescribing Providers In accordance with California Civil Code, Section 51303(k), the Alliance cannot reimburse providers for services ordered, prescribed, or rendered by a provider who is debarred, suspended, or otherwise ineligible from participation in the Medi-Cal program or included on federal debarment and suspension lists. Accordingly,

Likely documents
  • Confirm benefit details
  • Submit clinical notes if requested by the plan
Next actions
  • Confirm the current plan policy before submission.
  • Use the insurer authorization workflow for this listed code.