Once a request for prior authorization has been approved, when should service be initiated?
Response: Each authorized BHR service is expected to begin no later than 60 days after the initial request for services, unless the evaluation prescribes different time frames. Even if not provided, services will be considered to be initiated as authorized within 60 days of the initial request if services are documented to have been offered as authorized within the 60 days and: 1) the parent or recipient delays initiation of service; or 2) the amount of service offered is less than authorized and the family agrees that the amount offered is appropriate.29. Can the number of hours (vs. units) be indicated on the Prior Authorization Notice forms issued to providers by Medical Assistance (MA)? Now that a specific formula is used by MA to calculate the exact number of units that will be authorized, it’s hard for providers to tell exactly how many hours the number of units authorized equates to, since providers are provided with the exact formula now used by MA (i.e.
Response: Each authorized BHR service is expected to begin no later than 60 days after the initial request for services, unless the evaluation prescribes different time frames. Even if not provided, services will be considered to be initiated as authorized within 60 days of the initial request if services are documented to have been offered as authorized within the 60 days and: 1) the parent or recipient delays initiation of service; or 2) the amount of service offered is less than authorized and the family agrees that the amount offered is appropriate. 29. Can the number of hours (vs. units) be indicated on the Prior Authorization Notice forms issued to providers by Medical Assistance (MA)? Now that a specific formula is used by MA to calculate the exact number of units that will be authorized, it’s hard for providers to tell exactly how many hours the number of units authorized equates to, since providers are provided with the exact formula now used by MA (i.e., providers are still u
Related Questions
- If a Treatment Authorization Request (TAR) was approved for an audiology service (such as a hearing test) was obtained before July 1, 2009, will Medi-Cal cover the approved services if they are performed after June 30, 2009?
- Once a request for prior authorization has been approved, when should service be initiated?
- How quickly will a prior authorization (PA) request be approved or denied?
