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Wasteful and Inappropriate Service Reduction (WISeR) Model Prior Authorization

Wasteful and Inappropriate Service Reduction (WISeR) Model Prior Authorization form allows Part A and Part B Ohio providers to complete your prior authorization request inside the portal to be transferred to Innovaccer.

Part A providers Place of service will be Hospital Outpatient Department.

Part B providers Place of services are:

  • Ambulatory Surgical Center
  • Physician Office
  • Home Setting

Complete all fields with an *

The submission will be visible in the messages tab.

Also the decision letter will be sent to your inbox in the Messages tab.

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