Molinalogo

Requests for Inpatient rehabilitation hospital services require prior authorization. Rehabilitation requests are received on the MAD331 form in addition to preadmission assessment, history and physical, relevant therapy evaluations, and progress notes. Recipients must meet InterQual criteria. The approval is indicated on the MAD 331 form by the presence of an authorization number and Dates of Service. The updated form is then returned for notification to the requesting provider.