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Inpatient services
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All admissions including Medical,
Surgical, Transplant,
Rehabilitation, Skilled Nursing
Facility, Mental Health, Chemical
Dependency
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Durable Medical Equipment
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Prior authorization is required
for any DME greater than $750.
Claims for rental fees should not
exceed the allowed purchase
price. CPAP and BiPAP machines
require prior authorization.
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Home Care
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Home health nursing, IV
infusion, hospice, social work,
home health physical,
occupational, and speech
therapy.
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Notification is encouraged as soon as a pregnancy is confirmed. Certification is
required for Hospital stays exceeding 48 hours after a vaginal delivery or 96
hours after a cesarean. Please contact (614) 799-8722 (TPAC) or
(888) 735-8722 (TPAC).
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Blepharoplasty
Breast reduction or augmentation
Hyperbaric Oxygen
Removal of Port Wine Stains, Hemangiomas
Otoplasty
Rhinoplasty
Varicose Vein Surgery
Varicose veins ligation and sclerotherapy
Speech Therapy (Please note Speech Evaluations do not require Pre-
determination)
UPPP
TMJ and jaw surgery
ESWT of any extremity
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Health Services for Prior Authorization
and Pre-determination
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Local: (614) 799-8722 (TPAC) or
Toll Free: (888) 735-8722 (TPAC)
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