Thursday, 4 October 2012

How to get Authorization from OrthoNet for Physical Therapy and Occupation therapy for Humana?

Humana has delegated Medical Management responsibilities for physical, occupational and speech therapy services to OrthoNet for HMO, POS, EPO, PPO and Medicare Advantage members. OrthoNet’s scope of responsibility includes the management of the prior-authorization process for outpatient therapy services.

We need to submit the therapy request form to OrthoNet and need to fill the below information. Its need to be fax #1-800-863-4061

Therapy Provider Information

  • Facility Name
  • Street Address
  • City
  • State
  • Zip
  • Telephone Number
  • Fax Number
  • NPI
  • Provider Tax Id number
Patient Information
  • First Name
  • Last Name
  • Humana Member ID Number
  • Date of Birth
  • Diagnosis Code
Request Information
  • Service Type
  • Initial Evaluation Date
  • If this request for post or pre-operative therapy visits
  • If this is a Humana Medicare Advantage PFFS member, is this request for an Advanced Coverage Determination
You can retrieve this Authorization template in


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