Prior Auth Required

16937 - Topic #

This procedure appears on the selected insurer prior authorization source.

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Prior authorizationPrior Auth Required
Procedure / ServiceTopic #
Procedure / Service Description

Provider Electronic Solutions Software - software, providers may call the EDI (Electronic Data Interchange) Helpdesk. Topic #16937 Electronic Claims and Claim Adjustments with Other Commercial Health

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.