NJ Auto Attending Provider Treatment Plan Form

Dear Provider,

Please Complete the attached treatment plan form, which must be utilized for precertification requests. Please feel free to print and fax the completed form, along with a copy of the patient's most recent/appropriate progress notes, supporting medical documentation, and results of diagnostic test or studies relative to the requested services. Fax to the Hoover Precertification Department at 570-283-1637. If you have any questions, Please contact Hoover Rehabilitation Services at 877-704-4440, or email jdimaria@hooverinc.com.

NJ Auto Attending Provider Treatment Plan Form

New Jersey Auto Reform Decision Point Review Precertification Program Description and Summary