LAC 40:I.3507. Prior Authorization

A.1. All nursing services and personal care services described herein, except those specifically noted, must have prior written authorization of the carrier/self-insured employer before reimbursement will be made. Claimants should be notified of this requirement in writing upon the initiation of the claim. 2. Each authorization request must include a prescription or statement of need from the treating physician of record. The information provided by the prescribing physician must include, at a minimum: a. in addition to the medical report and written justification required above, a description of needed nursing or other attendant services, as well as specifying the level of nursing care (R.N., L.P.N., sitter/nonprofessional); and b. estimated period of need, including daily/hourly requirements for each level of nursing care. B. Prior authorization requests will be approved, denied, or amended and approved by the carrier/self-insured employer. Occasionally, some requests may be returned for further information, explanation, or reports. Once a request is approved, please take great care to bill only for those procedures or services specifically authorized by the carrier/self-insured employer. In addition, please attach the authorization letter to the invoice or enter the prior authorization number in the appropriate field on the invoice.