Prior Authorization Required for Non-Emergent Air Transportation Services

August 2018

Effective September 1, 2018, WSI will require prior authorization for non-emergent air transportation services, see North Dakota Administrative Code § 92-01-02-34.5(e). To request prior authorization, a provider must complete the Non-Emergent Air Ambulance Facility-to-Facility Request form and submit to WSI along with supporting medical documentation. WSI will notify the requesting provider of the authorization status within 24-hours, or by the end of the next business day.

To facilitate safe and cost effective air transportation for injured workers, WSI has established Memorandums of Understanding (MOUs) with several air transportation companies. Companies with current MOUs include Bismarck Air Medical, Trinity Health System, and TravelAire. It is WSI's expectation a provider will utilize these companies for non-emergent air transportation services.

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