Pre-authorizations
See which treatments that require pre-authorization by L&I or the self-insurer.
For pre-authorization or more information
Call the Provider Hotline at 1-800-848-0811, 8 a.m. to 5 p.m. weekdays. The Provider Hotline staff authorize:
- Radiology services and diagnostic testing
- Such as arthrograms, myelograms, bone scans, CT scans, EMGs and NVCs.
- Consultations,
- Durable medical equipment,
- Hearing aid services,
- Massage therapy,
- Non-targeted surgeries,
- Orthotics,
- Outpatient procedures,
- Physical therapy and
- Prosthetics.
Call Qualis Health for utilization review at 1-800-541-2894. Requests for review of the inpatient procedures is listed in Provider Bulletin 06-06 (151 KB PDF).
orCheck online, find out if treatment has been authorized on a claim.
Pre-authorization requests
Requests for pre-authorization must include a statement of:
- Condition(s) diagnosed,
- ICD-9 CM codes; including their relationship to the industrial injury/exposure,
- An outline of the proposed treatment program including its length and components,
- Procedure codes,
- Expected prognosis, and an estimate of when treatment would be concluded and condition stable.
Did you know?
The Provider Hotline can also answer your questions about:
- Bill payment or denial,
- Provider bulletins and updates,
- The Medical Aid Rules and Fee Schedule and
- Applicable sections of the Washington Administrative Code (WAC) or Revised Code of Washington (RCW).
For more detail, see:
Washington Administrative Code (WAC) 296-20-03001.
