Steps for United Medicaid Referrals:
 

1. Referral must be submitted on UHC Online via Link with referral AND office notes from PCP office.
2. Referral must be submitted to specific therapist (see Table 1 above) and discipline-specific evaluation code (see Table 2) for UHC approval.
3. Once referral is submitted, PCP office will receive an “A” number. Once referral is APPROVED, PCP office will receive an eight digit code (usually starting with 2).
4. Fax referral with UHC evaluation approval code to Arise Pediatric Rehabilitation (904-379-0113) and we will contact patient to schedule evaluation.
5. Once therapy evaluation is conducted, evaluation report will be faxed to PCP office for MD signature on plan of care.
6. Once plan of care signed by MD is received, Arise Pediatric Rehabilitation will submit for therapy visit authorization.
7. Once authorization received, patient will be contacted to schedule regular visits.

 
Steps for Humana Medicaid Referrals:

1. Referral must be submitted via Availity with referral AND office notes from PCP office.
2. Referral must be submitted to specific therapist (see Table 1 above) and discipline-specific evaluation code (see Table 2) for Humana approval.
3. Once referral is approved, PCP office will receive a nine-digit code (usually starting with 1).
4. Fax PCP referral with Humana evaluation approval code to Arise Pediatric (904-379-0113) and Arise Pediatric Rehabilitation will contact patient to schedule evaluation.
5. Once therapy evaluation is complete, therapy evaluation will be sent back to PCP office for PCP signature on therapy evaluation and therapy visit authorization.
6. Therapy evaluation with PCP signature on POC must be submitted by PCP office on Availity for therapy visit authorization using discipline-specific therapy code (see Table 3) for Humana approval.
7. Once Humana approval is received, therapy may begin. Arise Pediatric Rehabilitation will contact patient to schedule regular therapy visits!

Steps for CMS/Sunshine/ATA Referrals:
 

1. Fax referral to Arise Pediatric Rehabilitation (904) 379-0113 with diagnosis code and discipline.
2. Arise Pediatric Rehabilitation will contact patient to schedule evaluation.
3. Once evaluation is conducted, Arise Pediatric Rehabilitation will submit for authorization via Sunshine/ATA portal.
4. Once authorization is received, patient will be contacted to schedule regular therapy visits. 

Arise Pediatric Rehabilitation, 6817 Southpoint Parkway, Suite 1602 Jacksonville, FL 32216. All rights reserved.

Arise Pediatric Rehabilitation