BWC requires prior authorization for non-emergency treatment and services through the submission of a C-9 or its equivalent, to the MCO.
“Emergency” services are “Medical services that are required for the immediate diagnosis and treatment of a condition that, if not immediately diagnosed and treated, could lead to serious physical or mental disability or death, or that are immediately necessary to alleviate severe pain. Emergency treatment includes treatment delivered in response to symptoms that may or may not represent an actual emergency, but is necessary to determine whether an emergency exists.” OAC 4123-6-01(O)
Below is a link to the Standardized Prior Authorization Table for prior authorization requirements. The table does not include items meeting the presumptive approval criteria.
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