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CommercialPrior AuthHigh impact

Provider Alert - OrthoNet Descope

Healthfirst·Physical Therapy, Occupational Therapy, Podiatry +2 more·Prior Authorization
Effective date
Jan 1, 2024
We identified it
Jun 20, 2026
Days to comply

Summary

Effective January 1, 2024, Healthfirst is taking back responsibility for prior authorization requests for Physical, Occupational, and Speech Therapies, Podiatry Services, and Vascular Surgery from OrthoNet. Providers must now submit these PA requests directly to Healthfirst through their provider portal instead of through OrthoNet.

Action Required

Action needed
Immediately: Billing team must update prior authorization workflow to submit PA requests for Physical Therapy, Occupational Therapy, Speech Therapy, Podiatry, and Vascular Surgery services to Healthfirst Provider Portal (hfproviderportal.org) instead of OrthoNet for all dates of service on or after Jan 1, 2024. Create accounts on Healthfirst portal if not already established. Update staff training and encounter forms to reflect new PA submission process. Contact Healthfirst Provider Services at 1-888-801-1660 for questions.