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CommercialPrior AuthHigh impact

Mutual News Q3 2021 Newsletter

Medical Mutual of Ohio·Mutual News Newsletter
Effective date
Jan 1, 2022
We identified it
Jun 20, 2026
Days to comply

Summary

Medical Mutual will require clinical documentation to be attached to all prior authorization requests submitted through NaviNet starting January 2022. Providers will receive error messages if documentation is not included with their authorization requests.

Action Required

Action needed
By January 2022: Prior authorization staff must update workflow to attach clinical documentation to ALL Medical Mutual prior auth requests in NaviNet under the attachment section. Train staff that requests without documentation will generate error messages and be rejected. Update internal checklists to ensure documentation is always included before submission.

Affected Billing Codes

99202
99203
99204
99205
99211
99212
99213
99214
99215