July 1, 2009

 RE: Notification of New Carve-Out Vendor

 Dear Hospital Provider:

Recently you received notification that Peach State Health Plan (Peach State) was adding a new carve-out vendor, Therapy Review Systems, Inc. (TRS) to provide outpatient occupational (OT), speech (ST), and physical therapy (PT) services. In addition, a TRS contract packet was mailed to you for your review and approval. Listed below is information that will assist you with our new process as your work towards finalizing your agreement with TRS.

Effective July 1, 2009, Peach State will require all outpatient therapy services to be prior authorized through TRS.  If you do not yet hold a direct agreement with TRS, you still will be required to utilize TRS for prior authorization services. The TRS contact information for notification/prior authorization is as follows:

 TRS Authorization Request

Office: 1-866-409-7572, option 2

Web portal: www.thersys.com

Facsimile: 1-866-228-2471

Please submit claims for outpatient therapy to Peach State until your contract with TRS is finalized. Claims may continue to be submitted electronically or via paper at the address below.

Peach State Health Plan

PO Box 3030 

Farmington, MO 63640-3812

Attention: Claims Department

Reminder Note: Providers are allowed to service members for their initial evaluation without preauthorization. However, within 24 hours of this service, the provider must submit their clinical evaluation findings to TRS via fax at 1-866-228-2471.

Should you have any questions regarding this matter and would like to talk with a Peach State representative, please feel free to contact your Peach State Provider Solutions representative at (866)874-0633, or you may call your Provider Solutions Specialist directly.

Sincerely,

Provider Solutions

This entry is filed under News.