: Pennsylvania HealthChoices
Ensure you are compliant with the Ordering/Referring/Prescribing (ORP) claims requirement
The Ordering, Referring, and Prescribing requirement was effective for all claims submitted Jan. 1, 2018 and after. Communications and technical assistance have been provided throughout the year to ensure that we have the highest level of compliance.
What you need to do:
- Visit the Magellan of PA website for all information related to this important initiative.
- Review all documents with your billing teams to ensure that your agency is compliant.
- Maintain policies and procedures for employees or referring entities that are actively MA enrolled.
- Contact Magellan if you have any questions related to this initiative.
Although we are not currently editing claims based on submission of ORP, this may change early in 2019 depending on state recommendations. It is imperative that all your claims include this information to prevent future claims denials.
Contact us at PAHCPQuestions@MagellanHealth.com.