Important facts on submitting a Medical Prior Authorization Request (PAR) for Synagis®
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Colorado Department of Health Care Policy and Financing’s requirements for a Synagis® PAR for the 2015 – 2016
season can be found in the October 2015 Provider Bulletin.
Providers may submit a Medical Synagis® PAR through eQHealth Solutions beginning November 16, 2015
through April 30, 2016 to correspond with the immunization season.
Providers should submit the PAR using code 90378
How do I submit a PAR for Synagis®?
Providers can access the Medical Synagis® PAR form from the Synagis section of the ColoradoPAR website. This form
may be submitted to eQHealth in 3 ways:
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By calling 813.397.1879 for an immediate PAR determination.
o Providers should utilize this process if the client is currently in your office and you need an expedited
PAR determination.
o Having the form filled out before calling will expedite the PAR process.
Fax the completed form to 813.397.1783, or
Mail completed form to:
eQHealth Solutions
Attn: Colorado Medicaid Program
5802 Benjamin Center Dr., Suite 105
Tampa, FL 33634
What happens after I submit a Medical PAR for Synagis®?
A registered nurse will review the PAR and make a determination to approve it if it meets the criteria for medical
necessity. If the PAR does not meet medical necessity criteria, it will be reviewed by an eQHealth physician for a final
determination.
What happens if eQHealth needs additional clinical documentation to make a PAR determination?
eQHealth will contact the provider by phone to request additional clinical documentation. The provider has four (4)
business days to submit the additional documentation or the PAR will be denied for lack of information.
How do I submit additional clinical documentation when it is requested?
You may submit additional documents by going to the Synagis section of www.coloradopar.com to complete the
Medical PAR Synagis® form and send it to eQHealth Solutions by fax at 813.397.1783 or mail at the address listed above.
When will the PA# be available once eQHealth has completed review and how do I obtain it?
The approved PAR Identification Number (ID) is assigned by the Department’s Fiscal Agent and is typically available
within 24 hours following eQHealth's final PAR determination.
In what circumstances would be Medical Synagis® PAR be denied?
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eQHealth will attempt to contact you to discuss the PAR prior to issuing a PAR denial.
If your PAR is denied it may be denied for the following reasons:
o A technical denial for reasons such as a duplicate request.
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A denial when additional clinical documentation is not received within four (4) days of being requested.
A denial for not meeting medical necessity or not meeting the approved medical criteria.
What are my options if my Medical Synagis® PAR is denied?
You may request a PAR Reconsideration by calling 813.397.1879. For more information on the PAR process please
refer to www.ColoradoPAR.com
Who should I call if I have questions about submitting a Medical Synagis® PAR, or the overall PAR process?
More information on the PAR process can be found at www.ColoradoPAR.com or by calling eQHealth Solutions
Customer Service at 813.397.1879.