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Network Matters
News and Information for the
Harvard Pilgrim Health Care Network

August 2017

New Extended Care Facility Prior Authorization Request Form


To make the process of requesting authorization for extended care services faster and more efficient, Harvard Pilgrim has developed an authorization request form. The form details the information needed when requesting authorization for inpatient admission to an extended care facility, including skilled nursing facilities (SNFs – basic or subacute), acute rehabilitation facilities, and long-term acute hospitals (LTACs). 

The form is intended to increase the efficiency of the authorization process — eliminating the need for multiple back and forth calls between providers and Harvard Pilgrim’s care management staff due to missing information. Providers seeking authorization for extended care services should return completed their Extended Care Facility (ECF) Request Form by fax to 617-509-1147. If the patient requires medical transport by ambulance, providers must also complete the Non-Emergent Ground Transportation Prior Authorization Request Form.

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PUBLICATION INFORMATION

Eric H. Schultz,
President and Chief Executive Officer

Robert Farias,
Senior Vice President, Network Services

Annmarie Dadoly,
Editor

Joseph O'Riordan,
Writer

Kristin Edmonston,
Production Coordinator