The Provider Manual is a comprehensive guide of the requirements for Prior Authorization of elective procedures. It contains review templates for communication between the hospital and attending (surgeon) physician, as well as a reconsideration request form.
If a Prior Authorization is denied, a request for Reconsideration may be submitted by either the hospital or surgeon/physician within 10 business
days from the date of the denial notice, before admission for the procedure. Previously, we had 10 calendar days.
Click the link below to download the Provider Manual:
- Prior Authorization of Elective Procedures-Provider Manual