Retroactive Authorization Requests

NEMS may issue a retroactive authorization to a provider for services rendered if:

  • The service is medically necessary and appropriate at time of treatment
  • The service is related to continuity of care

Providers should submit a Treatment Authorization Request (TAR) form, with "Retro Request" indicated on the form within two (2) business days of the service. The TAR form should be faxed or mailed to the NEMS MSO Utilization Management Department along with the patient’s consultation reports, treatment notes and/or surgical reports for clinical consideration.

The turnaround time for issuing a retro authorization is five (5) business days after receipt of the request. The TAR form will be faxed back to the provider once a decision on approval or denial is made.