The Bainbridge Firm, LLC
Schedule a Free Initial Consultation

Toll Free:866-253-7107

Columbus : 614-545-9990

Portsmouth : 740-353-7548

Ironton :740-532-9772

Marion : 740-387-6727

Cambridge : 740-435-3342

Waverly : 740-835-8890

Springfield : 937-717-9407

What treatment services require pre-authorization?

The BWC's MCO standardized prior authorization table

Service Prior Authorization Required  No Prior Authorization Required
Physical medicine services, including chiropractic/osteopathic manipulative treatment and acupuncture Yes
Psychological services  Yes
Dental Yes
Evaluation and management services  Yes for psychological consults or chronic pain program consults  All other evaluation and management services 
Diagnostic testing  Yes. For drug test, please refer to the "Drug Testing" policy.  Basic X-rays 
Durable Medical Equipment (DME) 

Yes, if purchase price is equal or greater than $250

Yes, for DME rentals anticipated to or having the probability to exceed 80 percent of the purchase price of the DME

For DME, please refer to the "Durable Medical Equipment" policy. 

DME purchase price is less than $250
Home/Vehicle modifications  Yes. For home/vehicle modifications, please refer to the "Home and Vehicle Modifications" policy. 
Home health agency services  Yes
All inpatient and outpatient hospital services treatment and ambulatory surgery center services  Yes, unless for emergency services. Emergency inpatient hospitalization may be through the emergency department or by direct admission 
In-home physician services

Yes, after first visit

For in-home physician services, please refer to the "In-home Physician Visits and Physician Mobile Office Visits" policy. 

First visit 
Injections  Yes
Non-emergency ambulance (medical transportation) services  Yes
Orthotic  Yes, if greater than $250 
Prosthetic or artificial appliance and/or repair 

Yes, if greater than $250

For prosthetic or artificial appliance and/or repair, please refer to the "Artificial Appliance Requests" policy. 

Skilled nursing facility (SNF)/Extended care facility (ECF)  Yes
TENS and NMES units 

Yes, for both rental and purchase

For TENS and NMES units, please refer to the "TENS and NMES" policy. 

TENS and NMES monthly supplies 

Yes, with a maximum of six months per authorization

For TENS and NMES units, please refer to the "TENS and NMES" policy.

Vision and hearing services Yes, if greater than $100  Vision and hearing services less than or equal to $100 
Vocational rehabilitation - all vocational rehabilitation services, in or out of plan

Yes, unless meets the "NoPA Required" criteria

For vocational rehabilitation, please refer to the vocational rehabilitation policies (click here). 

Transitional work on-site therapy services provided by an occupational therapist that fall under the presumptive authorization criteria

Note: Occupational rehabilitation/Comprehensive (work hardening) requires CARF 

This means the requesting physician will need to submit a C9 requesting the listed treatments before payment of those treatments will be considered.

For questions or concerns, please contact our office at 614-545-9990.

No Comments

Leave a comment
Comment Information
email us for a response

Free Initial consultationCall us today for a free initial consultation. We promise to provide a response within a few hours.

Bold labels are required.

Contact Information
disclaimer.

The use of the Internet or this form for communication with the firm or any individual member of the firm does not establish an attorney-client relationship. Confidential or time-sensitive information should not be sent through this form.

close

office locations - we have Multiple Locations to serve you.

The Bainbridge Firm, LLC

Columbus Office
900 Michigan Avenue
Columbus, OH 43215

Toll Free: 866-253-7107
Toll Free: 800-762-1612
Phone: 614-545-9990
Fax: 614-224-9300
Map & Directions

Portsmouth Office
611 Court Street
Portsmouth, OH 45662

Toll Free: 866-253-7107
Toll Free: 800-762-1612
Phone: 740-353-7548
Fax: 740-353-1984
Map & Directions

Ironton Office
119 North Fifth Street
Ironton, OH 45638

Toll Free: 866-253-7107
Toll Free: 800-762-1612
Phone: 740-532-9772
Fax: 740-532-3127
Map & Directions

Marion Office
198 East Center Street
Marion, OH 43302

Toll Free: 866-253-7107
Toll Free: 800-762-1612
Phone: 740-387-6727
Fax: 740-382-5816
Map & Directions

Cambridge Office
120 Southgate Parkway
Cambridge, Ohio 43725

Toll Free: 866-253-7107
Toll Free: 800-762-1612
Phone: 740-435-3342
Fax: 740-435-3329
Map & Directions

Waverly Office
112 North Market Street
Suite B
Waverly, OH 45690

Toll Free: 866-253-7107
Toll Free: 800-762-1612
Phone: 740-835-8890
Fax: 740-835-8891
Waverly Law Office Map

Springfield Office
1021 N. Limestone Street
Springfield, OH 45503

Toll Free: 866-253-7107
Toll Free: 800-762-1612
Phone: 937-717-9407
Fax: 937-717-9408
Map & Directions