If a URO requests additional information from the treating physician and doesn receive that information within 14 days of receipt of the original request for authorization, what can the URO do?
A. There are two options if reasonably requested information is not received. A reviewing physician can either deny the request and state it will be reconsidered when the requested information is received or issue a notice of a delay until the information is received. The physician reviewer must issue either of these decisions within 14 calendars days of receipt of the original request.
A. There are two options if reasonably requested information is not received. A reviewing physician can either deny the RFA and state it will be reconsidered when the requested information is received, or issue a notice of a delay until the information is received. The physician reviewer must issue either of these decisions within 14 calendar days of receipt of the original request. A notice of delay may not be issued by a non-physician.
Related Questions
- If a URO requests additional information from the treating physician and doesn receive that information within 14 days of receipt of the original request for authorization, what can the URO do?
- If a carrier requests additional information from the treating provider, and the treating provider never sends the information, what happens to the claim?
- May a URO deny a request for authorization because the treating physician is not the MPN physician?
