All PlansPrior AuthHigh impact
Prior Authorization - Podiatry and Peripheral Vascular Disease
Healthfirst·Podiatry, Vascular Surgery, Cardiology·Prior Authorization
Effective date
Jan 1, 2024
We identified it
Jun 20, 2026
Summary
Healthfirst now requires prior authorization for podiatry and peripheral vascular disease services starting January 1, 2024. Providers must submit PA requests using a new 5-page fax form or through the online portal, including detailed clinical documentation and patient symptoms.
Action Required
Immediately: Billing team must implement prior authorization requirements for all Healthfirst podiatry and peripheral vascular disease services with dates of service on or after Jan 1, 2024. Update billing system to flag these services for PA. Train staff to use the new 5-page fax form (fax to 1-646-313-4603) or online portal at hfproviderportal.org. Ensure providers attach clinical notes from last 3 months, imaging reports from last 12 months, and complete detailed symptom documentation. Claims will be denied without proper prior authorization.