Prior Authorization of ServicesPrior authorization is notification to OSU MHCS of a request for benefits before receipt of specific services or before elective admission to a hospital or facility. If prior authorization is not obtained from OSU MHCS, a penalty will be assessed.
 Services that need prior authorization include, but are not limited to, the following:
- Physical Therapy (after 15 visits)
- Rental or purchase of medical equipment or supplies (over $300)
- Inpatient hospitalization
- Weight management programs and surgery
- Home health care services
- Admission to extended care facilities
- Behavioral health services (psychiatric or substance abuse)
- Select prescription medications (listing found http://hr.osu.edu/hrpubs/ben/medpriorauth08.pdf)
- Hospice care
- Purchase of prosthetic devices
- Inpatient maternity services
- Organ/Bone marrow transplant services
- Orthoptic therapy
- Medical Massage (initial visit)
- Occupational therapy (after 15 visits)
For a complete list of services requiring medical necessity review, click here or call OSU MHCS at (614) 292-4700 or (800) 678-6269.
All network providers have been contracted to accept the responsibility to complete all prior authorization paperwork for covered members. Your responsibility is to show your health plan card to make sure the provider understands you are on an OSU health plan and to make your copayment.
For providers who ask you, as a member, to obtain prior authorization or for non-network providers, call OSU MHCS Customer Service at (614) 292-4700 or (800) 678-6269 to obtain the necessary forms.
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