an explanation of benefits from any third-party coverage available to the client (for example: provincial plan, workers' compensation board, private insurance, education plan, etc.).additional relevant information the provider, physician, nurse practitioner, occupational therapist, or physiotherapist may have to support the request.the prescription or recommendation or referral form signed by an NIHB recognized prescriber for the requested benefit. ![]() To initiate the prior approval process, the Medical Surgical Prior Approval Form, found on the Express Scripts Canada NIHB provider and client website, must be completed in full and submitted to your NIHB regional office along with the following supporting documentation: General prior approval requirements can be found in the general policies. ![]() GEN-CCGF - Enrolled general MS&E or pharmacy provider with staff certified as a compression garment fitter.GEN - Enrolled general MS&E or pharmacy provider.Please refer to the provider section of the item tables below to identify the eligible provider of a specific item: The following is a list of NIHB recognized provider abbreviations found in this segment of the benefits list. WOCC(C) - Wound, Ostomy and Continence Certified (C)anada.(RN renewals only) - Registered Nurse (initial prescription required from MD, NP, NSWOC, WOCC(C)).NSWOC - Nurse Specialized in Wound, Ostomy and Continence.LPN/RPN - Licensed Practical Nurse/Registered Practical Nurse when within their scope of practice in their province/territory (renewals only).Please refer to the prescriber section of the item tables below to identify the eligible prescriber/recommender of a specific item: The following is a list of NIHB recognized prescriber/recommender abbreviations found in this segment of the benefits list. Items that are prescribed by prescribers/recommenders not recognized by NIHB will lead to denials or reversal of claims. Prescriptions or recommendations for coverage must be initiated by the health professionals identified as prescribers or recommenders of the specific item as listed in the tables. ![]() 13.1.2 Prescriber and provider requirements General information common to all medical supplies and equipment (MS&E) can be found in the general policies. 13.4.2 Alginates/hydrofibres/poly-absorbent fibres dressingġ3.1 General information 13.1.1 Benefit policies.13.1.7.1 Early replacement requirements.13.1.2 Prescriber and provider requirements.
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