Effective May 1, 2022
Vibra Health Plan (VHP) is making the following changes to our preauthorization procedures:
- A Vibra Preauthorization Requirements Code List will be implemented and available on the provider page.
- Beginning May 1, Durable Medical Equipment will be preauthorized based upon code and not based upon cost of item. Previously, items under $300 did not require preauthorization. Codes are defined within the Vibra Preauthorization Requirements Code List.
- Failure to obtain preauthorization for a service could result in payment reductions for the provider and benefit reductions for the member, based upon the provider’s contract and the member’s Evidence of Coverage.
- Services or medications provided without preauthorization may be subject to a pre-payment, medical necessity review.