Helpful Hints for MPW Chiropractic and Podiatry PA

• All Chiropractic and Podiatry PA requests must be entered through the NCTracks Provider Portal. Faxed or mailed requests will not be accepted.
• A signed and dated Referral from the OB/GYN is required (Medical assistant signature is not accepted).
• The MPW PA form (DMA-0002) on the NCTracks website can be used as the Referral or the referral can be written on the provider’s letterhead.  The OB/GYN must complete, sign and date the Referral. The Referral must be uploaded and attached to the PA request.
• If a provider is unable to upload the Referral (for whatever reason), the provider should print the prior approval cover sheet with the bar code, attach the Referral, and mail or fax them to CSRA.  Note that this method of submission will delay processing of the PA.
• The Referral must be dated prior to (or equal to) the effective begin date of the Prior Approval request.
• The Referral MUST state the reason why the treatment is medically necessary and how it is related to pregnancy.  The Referral cannot just say needs treatment for “pain”. Examples for Chiropractic are: Sciatica caused by pregnancy or limb numbness caused by pregnancy. Example for Podiatry is: The pregnancy is causing aggravation of an old condition and what that condition is.
• The Referral must state the specific number of visits being requested for the recipient. Only listing the number of visits on the detail line will result in the Prior Approval being sent back for additional information.
• PA requests are approved for up to a 60 calendar day duration.  If the recipient requires a longer period of time for treatment, a new Prior Approval request with a new signed and dated Referral must be entered into NCTracks.

For more information on MPW Chiropractic and Podiatry PA, see the February 12 announcement on the provider portal.