Referrals/Requests for Preauthorization

referral request


McLaren Health Plan Announces Change to Authorization Requirements for McLaren Health Plan’s Medicaid/Healthy Michigan Physical/Occupational/Speech Therapy Services, Effective May 2016

Effective immediately: McLaren Health Plan (MHP) is implementing a Pilot Program that removes the preauthorization requirement for in-network Physical Therapy (PT), Occupational Therapy (OT), and Speech Therapy (ST) for our Medicaid and Healthy Michigan Plan members only.

Although the administrative requirement of requesting authorization from MHP is being removed, it is always necessary for members to coordinate care with their Primary Care Physician to ensure that all care is medically necessary.

MHP will perform post-payment audits reviewing claims by diagnosis, number of visits, location and member. These audits will be performed to ensure medical necessity of services being performed. The audit process may result in requests for medical documentation. If it is determined that care has been given that is not medically necessary, claims will be re-adjudicated and offsets will occur on future claims payments

If you have any questions, please contact your Network Development Coordinator at (888) 327-0671.

McLaren Health Plan thanks you for the quality care you deliver!