Medical Mutual - Health Plans for Life

Documentation Standards, Forms and Policies

Consistent, current, legible and complete documentation is an essential component in quality patient care. A practitioner should be able to act on the patient’s behalf based on the medical record documentation information. With this goal in mind, Medical Mutual encourages practitioners to strive for compliance with the documentation standards, and provides the forms and policies below to assist in these efforts.

Office Site and Medical Record Documentation Standards

Home Health Care Request Forms

Effective immediately, Medical Mutual is suspending its policy that requires home healthcare providers to obtain prior authorization for services. This means you are no longer required to obtain prior authorization for services delivered to Medicare Advantage members after 120 days. Additionally, no prior authorization is needed for commercial members requiring occupational therapy (OT), speech therapy (ST), home health aide (HHA), skilled nursing visit (SNV) and physical therapy (PT) visits beyond 120 days. Regardless of these changes, it is the home health provider’s responsibility to ensure that services provided to Medical Mutual members are medically necessary to be considered a covered service.

Throughout 2019, we will work to align our population health care model with a network of high-quality post-acute providers. The intent of this effort is to develop strong relationships that maximize the number of patients treated by this network and to advance care models that improve health outcomes and lower costs.

As a valued healthcare partner, we thank you for caring for our members. If you have questions, please contact your provider contracting representative.


acrobatTo view the PDF files, or if you encounter an error opening the PDF files on this site, download and install the latest free version of Acrobat Reader.

This Medical Mutual website may contain links to other Internet sites (“Third Party Sites”) that are not maintained by or under the control of Medical Mutual. These links are provided solely for your convenience, and you access them at your own risk. Medical Mutual makes no warranties or representations about the contents of products, services or information offered in such Third Party Sites. Consequently, Medical Mutual is not and cannot be held responsible for the accuracy, copyright compliance, legality or decency of material contained in Third Party Sites linked to this Medical Mutual website.

© 2019 Medical Mutual®