To help ensure that authorization and medical necessity concerns are addressed in a timeline manner prior to a procedure, here are a list of best practices:

• Prior authorizations should be requested by the surgeon’s office with the patient’s insurance plan a minimum of five to 14 days prior to the service date, depending on the length of time the payer requires to approve, but no less than five days in advance.
• Prior authorizations for procedures at HonorHealth Piper Surgery Center should be obtained under the name and NPI of HonorHealth Scottsdale Shea Medical Center (#1386608859).
• Prior authorization for procedures at HonorHealth Greenbaum Surgical Specialty Hospital should be obtained under the name and NPI of HonorHealth Scottsdale Osborn Medical Center (#1811951429).
• Any implants that are known to be used at time of scheduling should be included on the surgery scheduling form or disclosed to the HonorHealth Central Surgery Scheduling team.
• HonorHealth Pre-Services validates authorizations are in place and ensures the authorization matches the patient status requested (inpatient/outpatient).
• If there is no prior authorization in place 24 hours prior to a procedure time, the procedure should be rescheduled to a date after the authorization is approved or the patient may sign a waiver accepting financial responsibility to move forward.
• Pre-services verifies that the procedure/surgery meets the medical necessity policies of the patient’s insurance plan for the procedure to move forward; if not met, the procedure should be rescheduled to a point in time after the medical criteria are met or the patient may sign a waiver accepting financial responsibility to move forward.
• If the patient has Medicare and the procedure is one that requires the hospital to request prior authorization, the procedure should be scheduled out a minimum of 14 days in advance, since Medicare (Noridian) requires at least 14 days to process the authorization request. All applicable clinical documentation to substantiate the medical necessity of the procedure should be promptly provided, when requested.

Each surgeon’s office receives an emailed report twice a week with a list of surgeries scheduled for “tomorrow” to 21 days into the future that may/will need prior authorization from a patient’s insurance plan. The purpose of the report is a reminder to check on prior authorization requirements with patient’s plan and/or submit the prior authorization request to the insurance plan as soon as possible. Not receiving this report? Please ensure your practice email address is on file with HonorHealth Central Surgery Scheduling or contact pre-services to have it added.

We appreciate your cooperation and collaboration in providing an exceptional patient experience to all our mutual patients.

If you have any questions, please contact HonorHealth Pre-Services Department:

• Sherrie Sutton, pre-services supervisor
  • Phone: (623) 300-9192
  • Email: [email protected]
• Mallory Thompson, pre-services supervisor
  • Phone: (623) 300-9194
  • Email: [email protected]
• Ginger Beard, MBA/HCM, pre-services network director
  • Phone: (623) 229-1014 (cell)
  • Email: [email protected]