(insertion, replacement, upgrade) Resting transthoracic X echocardiography Transesophageal X echocardiography OTHER SERVICES Bone density X X Cardiac rehab X X X X X Occupational therapy X X (after X eval & 1st 6 visits) Outpatient surgical X Per Per Per Per X X X X X plan/call plan/call plan/call plan/call Pain procedures X X Physical therapy X X X X X (after X X eval & 1st 6 visits) Pulmonary rehab X X X X X X X – initial service study X X Per Per Per Per X X X plan/call plan/call plan/call plan/call Sleep follow-up X X X X X AUTHORIZATION METHODS Phone Ereferrals option 3 options 1,4,1,2 Alternate phone EviCore PT/OT Pulm Rehab Web United Health Med Healthcare Help Solutions
(insertion, replacement, upgrade) Resting transthoracic echocardiography X Transesophageal echocardiography X OTHER SERVICES Bone density X X Cardiac rehab X X X X X Occupational therapy X X (after eval & 1st 6 visits) X Outpatient surgical X Per plan/call Per plan/call Per plan/call Per plan/call X X X X X Pain procedures X X Physical therapy X X X X X (after eval & 1st 6 visits) X X Pulmonary rehab – initial service X X X X X X X study X X Per plan/call Per plan/call Per plan/call Per plan/call X X X Sleep follow-up X X X X X AUTHORIZATION METHODS Phone Ereferrals option 3 options 1,4,1,2 Alternate phone Pulm Rehab EviCore PT/OT Web United Healthcare Health Help Med Solutions
10.1001stepsforward.2017.0100supp3.docx