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7.4.5.3 Prior Authorization Requirements
To receive payment for services to ValueOptions clients, providers must be enrolled with ValueOptions. (Exceptions include emergency care and medically necessary treatment episodes that began before the client joined a NorthSTAR plan.) ValueOptions requires that the provider obtain prior authorization for most nonemergency services. If the provider does not obtain prior authorization, they may not get payment for services. These rules apply whether the provider's practice or facility is located in or out of the Dallas SA.
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