Remember Your Clinical Documentation
To consistently provide quick, accurate determination decisions for you and your patients, we need your assistance. When submitting prior authorization requests, be sure to always provide complete and accurate clinical documentation.
This will help us best serve your patients and stay compliant with federal regulations. If we don't receive sufficient information to determine medical necessity, we may have to deny your request.
For reference, here are the required response times for various requests.
Part B Drug Requests
- Expedited: within 24 hours
- Standard: within 72 hours
All Other Requests
- Expedited: within 72 hours
- Standard: within 14 days