01Providers: submit authorization requests through the Provider Portal first, and call the UM Call Center only for clinical conversations.
02Recuperative Care: download the Recuperative Care SAR from the L.A.
03Care website, complete it and indicate member consent, then submit it with supporting documents by secure fax to 1.213.536.0634 within 48 hours of the member's admission into the Recuperative Care facility.
04For requests made directly to L.A.
05Care, attach the face sheet, history and physical, medication list, wound care notes, psych notes if applicable, and assessment of ADLs/IADLs.
06For emergency room requests, attach the face sheet, ED labs and tests, ED chart notes, supporting social work or paramedic notes, and the ADL/IADL assessment.
07Notify L.A.
08Care as soon as possible if discharge delays or changes in the member's case will affect the SAR.
09Cases that do not meet criteria will not be approved and will not be billable to L.A.
10Care.
11Discharge planning from long-term care: fax orders for DME, home health, transportation and specialty follow-up at least 7 to 10 days before discharge, and include the HCPCS and CPT codes that need authorization.
12Send the MC171, discharge summary and medication reconciliation to L.A.
13Care at discharge, and notify your L.A.
14Care nurse or coordinator so enrollment back to a community PPG can take place.
15Fax authorization requests to 213.498.5777, or urgent requests to 213.438.6100; allow 5 business days for routine requests and 72 hours for urgent requests.
16Arrange transportation in advance for follow-up appointments and continued dialysis.
17Direct Recuperative Care questions to recupcare@lacare.org.