Healthfirst

Effective Jan. 1, 2024, Healthfirst will resume responsibility for management of prior authorization requests for all of the following services: Physical, Occupational, and Speech Therapies; Podiatry; and Vascular Surgery.

Starting Jan. 1, 2024, you can submit prior-authorization requests for these services to Healthfirst for dates of service on or after Jan. 1, 2024.

OrthoNet will continue to manage pain management and spinal surgery authorization requests on Healthfirst's behalf.

If you require assistance, please call Healthfirst Provider Services at 1-888-801-1660, Monday to Friday, 8:30am-5:30pm. https://hfproviderportal.org

Spinal Surgery and Pain Management

Healthfirst has delegated the utilization management of spine surgery, as well as interventional pain management procedures (not including trigger point injections) in all outpatient settings to OrthoNet. These procedures and their CPT codes are listed on the applicable OrthoNet Codes Requiring Authorization List which can be viewed at Healthfirst's website (https://hfproviderportal.org).

See Frequently Asked Questions (FAQs) for the Management of Requests Formerly Handled by OrthoNet

Services for members covered by Healthfirst's programs require prior authorization through OrthoNet. Healthfirst will continue to provide all other related services for these procedures such as claim payment, patient case management, member and provider services.

Clinical Criteria used for Pain and Spine Utilization Management

Prior Authorization Submission
and
Status
To begin using our secure site; you must create a user account.
  • New User-Account Request Form

    • To submit authorization check status
  • Request Authorization or Check Status

    • Click on the Web Portal FAQ for Step by Step directions.

    Contact
    Pain Management
    844-504-8091
    Fax: 844-478-8250

    Spinal Surgery
    844-504-8091
    Fax: 844-478-8250

    Health Plan Web Sites
    Click here to access HealthFirst's website