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San Joaquin Health Care 2004 JPA Handbook

PPO Plans / Prior Authorization
YOUR SISC SPONSORED PPO PLANS
PRIOR AUTHORIZATION
The Authorization program provides prior authorization for medical care or services by a non-participating provider and for certain "special services."
It is your responsibility to obtain authorization before you receive any services subject to the authorization program. The toll-free number to call for authorization is shown on your Plan Identification Card.

If you receive any such service and do not follow the procedures set forth in the Plan Document, your benefits will be reduced as shown in the Effect on Benefits portion of the Authorization Program located in the Plan Document.

Services Requiring Authorization:
    Organ and Tissue Transplants
    Home Infusion Therapy
    Home Health Care
    Admission to a Skilled Nursing Facility


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San Joaquin JPA Handbook 2004