Provider Manual - Aplos Health Plans

Welcome to the Aplos Health Plans provider reference tool!

If you have any questions, please call (844) 498-3347

Services that require pre-authorization:

Inpatient / residential admissions

Medical & Surgical
Mental health
Substance use disorder
Long term acute care (LTAC)
Inpatient rehabilitation
Skilled nursing facility (SNF)
Hospice

Elective surgical procedures performed (excluding procedures performed in a physician's office)

In hospital outpatient/ambulatory settings
In ambulatory surgery center

Outpatient treatment programs

Partial hospitalization programs
Intensive outpatient programs

Outpatient therapy services

Physical therapy
Occupational therapy
Speech therapy
Applied behavioral analysis (ABA)

Home-based treatment

Home health including nursing and therapies
Home IV infusions
Hospice

Durable medical equipment (DME) over $500

Other services

Genetic Testing
Allergy Testing
Sleep Studies
Nerve Conduction Studies
Radiation therapy
Chemotherapy
Dialysis
Genetic Testing
Biologics, Immunotherapy and Gene Therapy
Transplants and Transplant Evaluations
Injectable medications
Infusions
Interventional pain management
Vein procedures, regardless of the site of service
Join injections, regardless of the site of service
Blepharoplasty, regardless of the site of service

Downloadable Forms

Please submit all complete forms to aplos@innovativecare.com

Please submit all claims to:

Aplos Health Plans
P.O. Box 95600
Hoffman Estates, IL 60195
EDI #36338

Simple. By design.

Get started with Aplos today! Simply enter your email below and we will reach out to you with more information.

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