HealthLink Requires PT Pre-Certification
Several members have contacted the Illinois Chiropractic Society regarding recent physical therapy denials from HealthLink. The EOBs indicate the following: “This service has been rejected for failure to obtain precertification for the service rendered.”
Although unenforced until recently, HealthLink policy (document dated August 2010 and updated July 2011) requires pre-certification of all physical therapy regardless of provider type. Based on the information received by the ICS, HealthLink is now enforcing that policy.
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We are recommending the following:
- Pre-certify ALL “physical therapy” services (and all other services mentioned in the HealthLink Standard Medical Necessity Review Checklist) with HealthLink beginning today, and
- Appeal all previous denials indicating the medical necessity and your ongoing compliance with the pre-certification policy.
For more information here are some important links:
- HealthLink Standard Medical Necessity Review Checklist (July 2011)
- HealthLink Provider Notification Letter (May 2011) –
HealthLink Medical Management Announces Addition of Specialty Infusion Drugs to the HealthLink Pre-Certification List - HealthLink Utilization Management Page
As always, the ICS strongly urges our members to read all medical and related policies of all contracted insurance companies and networks. Additionally, physicians should familiarize themselves with the provisions contained in the PPO contracts signed.
