Office of Managed Care Operations

Referral Requirements for Physical Medicine & Rehabilitation Services

OUTPATIENT SERVICE

 

Managed Care Organization

Physical Therapy

Occupational Therapy

Speech Therapy
Aetna US Healthcare (Excluded OP service at UH.)

EXCLUDED SERVICE

EXCLUDED SERVICE

EXCLUDED SERVICE
Americaid Community Care Inc.

X

X

X
AmeriHealth, Inc. (Excluded OP service at UH.)

EXCLUDED SERVICE

EXCLUDED SERVICE

EXCLUDED SERVICE
Empire Blue Cross

HMO-Yes

PPO- No

POS (In-network)-Yes

POS(Out-of-netwk)-No

HMO-Yes

PPO- No

POS (In-network)-Yes

POS(Out-of-netwk)-No

HMO-Yes

PPO- No

POS (In-network)-Yes

POS(Out-of-netwk)-No
First Option Health Plan

Pre-Auth

Pre-Auth

Pre-Auth
Horizon Blue Cross & Blue Shield of NJ

Pre-Auth

Pre-Auth

Pre-Auth
HMO Blue

Pre-Auth

Pre-Auth

Pre-Auth
Managed Healthcare Systems of NJ

X

X

X
Mercy Health Plans/Harmony

X

X

X
University Health Plans

X

X

X

Note: All of the above HMOs participate with University Hospital.

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Last Reviewed:February 2004
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University Hospital
150 Bergen Street
Newark, NJ 07103 USA
(973) 972 - 4300