Absolute Total Care (Medicaid Plan) Updated Guidance for Medicaid BabyNet Therapy Providers

Date: 03/01/22

As a valued partner, we want to ensure that you are aware of changes Absolute Total Care is making that affect Medicaid BabyNet therapy providers.

Effective March 1st, 2022, Absolute Total Care will no longer require Medicaid BabyNet therapy providers to submit an individualized family service plan (IFSP) or Universal Prior Authorization Form for service authorization for members enrolled in the SCDHHS BabyNet Program.

Authorizations for BabyNet therapy services will no longer be issued by Absolute Total Care for members enrolled in the SCDHHS BabyNet Program. Claims for services rendered to members enrolled in the SCDHHS BabyNet Program may be submitted without prior authorization for payment.

Absolute Total Care reserves the right to request IFSP’s and other documentation retrospectively on an as-needed, or ad-hoc basis, to support post-payment reviews as well as any state or federal audits.

Note: Prior authorization is required for physical, speech and occupational therapy services for all members that are not enrolled in the SCDHHS BabyNet Program. Providers rendering the services to members that are not enrolled in the BabyNet Program should verify that the necessary authorization has been obtained. Failure to do so may result in non-payment of your claim. Please visit the NIA website for more information.

Please contact your Provider Relations Representative or call Provider Services at 1-866-433-6041 with any questions you may have.