LAC 40:I.3707. Prior Authorization

A. Requests for home or vehicle modifications will most often originate from the claimant or a vocational rehabilitation consultant. B. A request for modification or repair of a dwelling must be substantiated by detailed estimates listing the following: 1. exact nature of work to be done; 2. itemized cost of materials; and 3. total cost of labor broken down by total hours and hourly rate. C. 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, take great care to bill only for those modifications specifically authorized by the carrier/self-insured employer. In addition, a copy of the prior authorization letter should be attached to the invoice/billing.