Health Tradition covers all medically necessary services. Your provider may have
to request plan approval for some services before you receive them. This is called
a “prior authorization.” Utilization Management can be reached at
608-781-9692 or 1-888-758-7848.
Routine and Specialty Care
No prior authorization required when seen by Health Tradition network providers.
Urgent Care
No prior authorization required when seen by Health Tradition network providers.
Emergency Room Care
No prior authorization required. Emergency room care is for true emergencies. Go
to a Health Tradition provider for help if you can.
Physical and Occupational Therapy
No prior authorization required when seen by Health Tradition network providers.
Speech Therapy
Referral is required prior to receiving services. Your provider must send an external
referral form to Health Tradition for prior approval.
Durable Medical Equipment (DME)
Referral is required prior to receiving items from Mayo Clinic Health System - Franciscan Healthcare Home
Health Services that cost $750 or more. Certain items less than $750 may also require
prior authorization. Home Health Services will assist you with identifying these
items.
Elective Inpatient Admission
Prior authorization required by calling Utilization Management at Health Tradition.
Emergency Inpatient Admission
Certification required within 48 hours by calling Utilization Management at Health
Tradition.
Home Healthcare Services
Prior authorization required by calling Utilization Management at Health Tradition.
Hospice Services
Prior authorization required by calling Utilization Management at Health Tradition.
Skilled Nursing Facility
Prior authorization required by calling Utilization Management at Health Tradition.
Out-of-Network Services
All out-of-network services require prior approval from the health plan.
Mental Health/AODA Services
Contact the Mental Health Coordinator at 608-781-9692 or toll-free at 1-800-758-7848
for information on benefits and prior authorization.
Birth to Three Services
Referral is required prior to receiving services. Your provider must send an external
referral form to Health Tradition for prior approval.