In order to increase provider satisfaction, reduce provider friction and improve fiscal outcomes surrounding the authorization process for the services noted below, AdventHealth Advantage Plans (“AHAP”) will no longer partner with Palladian for spine care management and other musculoskeletal conditions effective Oct. 1, 2020.
- Spine Pain Management
- Spine Care Advocacy
- Spinal Surgery
All requests that previously were sent to Palladian for authorization review (i.e. spinal injections, spinal surgeries) will now be reviewed directly by nurses and physicians at AHAP. In-network providers should submit their request via the provider portal in MHK to ensure the quickest turnaround time. Faxing the request is still an option but will result in turnaround times of up to 14 calendar days.
What plans were included in the Palladian review?
All fully insured Commercial Plans, all Medicare Advantage Plans, Health First TPA Plan and Brevard County TPA Plan are affected by the change.
*NOTE: AdventHealth TPA and Rosen TPA Plans are unaffected by this change.
How does this affect your practice?
Any request for dates of service on or after October 1, 2020 should be sent to AHAP via the provider portal in MHK for review. Dates of service prior to October 1, 2020 should still be sent to Palladian.
Additionally, you will no longer need to fill out the forms that Palladian required for each authorization review. AHAP will require standard authorization information such as requesting or servicing provider, facility (if applicable), CPT/HCPCS codes, ICD-10 codes, dates of service, and most importantly supporting clinical information and notes.
If you have previously had an authorization granted by Palladian, it would be helpful to note this in the authorization request that you send to AHAP. This will help increase efficiency by reducing the need the Health Plans’ associate to verify information in the Palladian system.
Where do you go for answers to your questions?
Contact your population management advisor or provider network specialist if you have any questions or need assistance accessing the provider portal or Customer Service at the number below.
AHAP Provider Line: 1-844-522-5278 (TTY/TDD Relay: 711)