Certification

The Health Care Management Division is responsible for certification of the following services:

• Botox Injections (non-cosmetic)
• Chiropractic therapy –visits exceeding 20 per calendar year must be certified; limited to 60 visits per calendar year.
• Dental accidents
• Durable medical equipment (DME)
• Enteral feeding
• Hearing aids – covered only for dependent children up to age 18
• Home health care – may be approved for up to 100 visits per calendar year
• Home infusion therapy
• Hospice – requires physician statement of life expectancy of six months or less
• Mental Health Home Services – covered only for six biologically-based diagnoses (schizophrenia, bipolar disorder, manic depressive illness, major depressive disorder, panic disorder, obsessive-compulsive disorder, and schizo-affective disorder)
• Non-emergency ground or air ambulance
• Occupational therapy - visits exceeding 20 per calendar year must be certified; limited to 60 visits per year
• Oral Surgery – outpatient
• Orthotics and Prosthetics
• Orthotripsy
• Outpatient hyperbaric oxygen therapy
• Outpatient mental health/substance abuse treatment – visits exceeding 15 per calendar year must be certified; limited to 26 visits per calendar year
• Physical therapy – Certification must be initiated and approved for visits exceeding 20 per calendar year; limited to 60 visits per calendar year
• Speech therapy – Certification must be initiated and approved for visits exceeding 20 per calendar year; limited to 60 visits per calendar year.
• Temporomandibular Joint Dysfunction (TMD) treatment
• Visco supplementation injections of the knee

To obtain certification, please have your provider contact the Health Care Management Division at 1-405-717-8879 or toll-free 1-800-543-6044, ext. 8879.