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Printed Date: 9/22/2015
Expedited requests for prior authorization are based upon the medical condition of the beneficiary. Reasons that are a reflection of additional documentation submitted, supplier financial status, etc. will not be processed as expedited.
For additional information, please review the FAQs below:
The patient is discharged from the hospital with an order for repetitive transports that begin within 48 hours of discharge. We provide the four initial transports right away within a few days. The Prior Authorization (PA) request takes ten business days to come back and we have provided more than the initial four transports. Can we submit this as an expedited PA request?
Answer: If the transports are for dialysis only:
If the transports are also for something else, such as wound care:
I submitted an expedited Prior Authorization (PA) request. What happens if it does not qualify for expedited processing? Do I need to send another PA request?
Answer: No, you do not need to submit another request. If it is determined that the submitted information does not support expedited processing, your request will be moved to the regular PA request workload to be processed as normal.
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Last Updated: 07/28/2017