Guest guest Posted February 15, 2012 Report Share Posted February 15, 2012 All you need to do is check yes and send it back along with the original fax form and initial eval. They will notify you of your visits in a day or 2. In the future when you fill out the " Humana Therapy Fax request form " you need to check " yes " in the box on the bottom right of the form that asks- " If this is a HUMANA Meducare Advantage PFFS member, is this a request for an advanced Coverage Determination (ACD)? " . Mark " YES " in the future and you will not get the second letter and will not have to re-fax. Ortho Net request After meeting the notification requirement required by OrthoNet, a contracted vendor for a Humana Medicare patient, our office recently received a FAX from OrthoNet as follows; " We encourage you to request an advanced coverage determination before the start of the service or procedure identified above so that a decision can be made on the medical necessity of the procedure or service. Simply check the 'yes' box below to indicate you are requesting an ACD. Then fax this letter with the appropriate supporting clinical documentation to us at.. Has anyone else out there received something like this recently? Is this even reasonable? We have never had a request like this before. If someone can shed some light on this for us it would be appreciated. Quote Link to comment Share on other sites More sharing options...
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