Our Brands:
Small |
Medium |
Large |
Extra Large |
XXL+ |
| T4525 | T4526 | T4527 | T4528 | T4544 |
| $.086 ea | $1.01 ea | $1.10 ea | $1.25 | $2.25 |
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All incontinence orders require Prior Authorization through Title 19.
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Our staff will gather the necessary paperwork for Prior Authorization.
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If Title 19 denies the requested order, we will contact the case manager to submit the order to Advantage Waiver for approval.
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You will receive updates in Harmony on our progress.
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For additional qunatities, the case manager will add the overage to the member’s Advantage service plan.
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9ll incontinence orders require Prior Authorization through Title 19.
-
Our staff will gather the necessary paperwork for Prior Authorization.
-
If Title 19 denies the requested order, we will contact the case manager to submit the order to Advantage Waiver for approval.
-
You will receive updates in Harmony on our progress.
-
For additional qunatities, the case manager will add the overage to the member’s Advantage service plan.
Small – T4521 $0.80 ea
Medium – T4522 $0.85 ea
Large – T4523 $0.96 ea
Extra Large – T4524 $1.13 ea
2XL+ – T4543 $2.25 ea
Disposable
Reuseable
