PhotoFrequently Asked Questions

What is the State Fiscal year for NH Medicaid?

The State Fiscal year runs from July 1st to June 30th.

What do I need to include in an authorization?

All requests need to be submitted on the proper form. DME request must include a Letter of medical necessity or a script with a diagnosis on it. All radiology request must include clinical information.

What is the turn around time once I submit an authorization request?

The type of authorization will depend on the TAT. Radiology requests have a 2 business days TAT. DME and SLO pre-service requests have a 10 business day TAT. All post-service requests have a 30 business day TAT.

How long with the authorization be for?

Authorizations are typically for a 3 month time span, however it is important to verify the begin and end dates when you receive the authorization.

What clinical criteria is needed for incontinence supplies?

Authorization for incontinence items will be approved in accordance with the clinical criteria below. Urinary stress incontinence is not a covered condition.

The recipient’s type of stress incontinence must be:

  • Secondary to a disease process which results in irreversible loss of control of the urinary bladder and/or rectal spincter; or
  • Secondary to an injury to the brain or spinal cord; or
  • Attributed to a profound cognitive disability, such as severe mental retardation or dementia, that results in an inability to achieve continence through bladder training.