To request corrections to authorizations that have been approved for dates of service on or after 7/1/2020, please complete the following information:
Please note that initial and retro-authorization requests will not be accepted through this box.
Requests to add codes will not be accepted via this form. If you need to add a code, prior to May 1, 2021 you may submit an authorization through the Incedo portal, backdated to the start of the original authorization, for the desired code. If the desired code does not display on your authorization request screen, this may be due to an issue with your profile set-up, please contact provider relations.