Questions? Call (888) 705-5274
If you are submitting additional documents in regards to a previous re-authorization request, please complete the required fields and scroll down to the Additional Information section.
Add visits for a discipline already in the home
*** Must include current measurements and color wound photos ***
Add check for discipline(s) that are NOT already in the home
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RA notification to agency confirms receipt of determination with approved visits. Should you disagree with approval, please notify PHCN UM Department at (888) 705-5274. Should a material change in member status occur, submit an additional request with pertinent clinical documentation.