Prior Auth Required
1860D - 15.14.2 As provided under section -14 of the Social Security Act, full-benefit dual
This procedure appears on the selected insurer prior authorization source.
Prior authorizationPrior Auth Required
Procedure / Service15.14.2 As provided under section -14 of the Social Security Act, full-benefit dual
Procedure / Service Description
The Contractor must pay Medicare coinsurance and/or deductibles for covered services provided to dual - 15.14.1 Dual eligible members shall have choice of all providers in the network and shall not be restricted to those that accept Medicare. 15.14.2 As provided under section 1860D-14 of the Social Security Act, full-benefit dual eligible institutionalized individuals have no cost-sharing for covered Part D drugs under their PDP or MA-PD plan. Effective January 1, 2012, Section 1860D-14 of
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.