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The following services require the members provider to contact Ambetter from Sunshine Health for prior approval: THE FOLLOWING LIST IS NOT ALL-INCLUSIVE Ancillary Services Air ambulance transport Durable Medical Equipment (DME) Home health care services Hospice Furnished medical supplies Orthotics/prosthetics Genetic testing Quantitative urine drug screen Procedures/Services Reconstructive Surgery Experimental or investigational High Tech Imaging administered by NIA (CT, MRI, PET) Submit requests to RadMD.com Pain management Cardiac and respiratory therapy Inpatient Admissions All inpatient admissions (within 1 business day of admission) Observation stays exceeding 48 hours Notification is required within one (1) business day if admitted Transplants (not including evaluations Urgent/emergent admissions Partial inpatient, PRTF, and/or intensive outpatient programs All elective/scheduled admission notifications requested at least five (5) days prior to the scheduled date of admit including but not limited to: Medical admissions Surgical admissions Hospice care Rehabilitation facilities Out-of-Network Services: All out-of-network services and providers require prior authorization, excluding emergency services

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