Download - Advantus Network

2017 MEDICAL PRIOR AUTHORIZATION REQUIREMENTS
ADVANTUS NETWORK
Provider MUST obtain prior authorization through ADVANTUS
Prior Authorization Requirements
 Inpatient hospitalization
 Partial Hospitalizations
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Advanced imaging: PET/SPECT & MRI’s (Spine only)
Durable Medical Equipment > than $750
Home Health Care
Home IV Therapy
Hospice Care
Skilled Nursing Facility
Chemotherapy/radiation
Cardiac & Pulmonary Rehab
Physical Therapy
Occupational Therapy
Speech Therapy
Corrective Appliances/Prosthesis
Biotech Drugs*(See Below)
Wound Treatment
Sleep Study (only Out Patient overnight studies done in a sleep center)
Pain Management
Transplants
Specialty Pharmacy Prior Authorizations:
*Biotech medication requests will be completed by
Magellan Specialty Pharmacy:
Prior Authorization Phone:
800-424-0472
Prior Authorization Fax:
800-424-3260
The product will then be delivered per the direction of the ordering physician*
1/1/2017