Prior Approval in Cases of Emergency

Section 140 Section 140.41  Prior Approval in Cases of Emergency a)         In cases of emergency, the provider may request prior approval by telephoning the office that gives such approval.  "Emergency" is defined as a condition or situation which threatens the recipient's life or may cause permanent damage, or requires services which, in the opinion of the attending physician, are needed to relieve immediate pain and suffering. If a recipient's condition is so severe that his or her life is endangered and there is not enough time to seek approval by telephone or the service is needed during non-working hours, the service may be provided before obtaining prior approval. b)         When emergency approval is obtained by telephone, or the service is provided before obtaining approval under the above circumstances, the provider must still submit a written request in order to receive approval to bill for the services provided.