Changes to Service Authorization Timeframes Effective April 1, 2026
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Defines updated decision timeframes for service authorization requests, including a specific expedited process for inpatient rehabilitation after hospital admission; affects Fidelis Care members and providers.
Member handbook updated to include revised service authorization timeframes effective April 1, 2026.
Decision timeframe for inpatient rehabilitation requests after an inpatient hospital admission: decision within 1 work day once all information is received, but no later than 7 days after receipt of the request.
Provider Actions and Authorization Timeframes
Inpatient rehabilitation authorization timeframe
For inpatient rehabilitation service requests following an inpatient hospital admission, a decision will be made within 1 work day after receipt of all required information, but no later than 7 days after receipt of the request. The requester will be informed by the 7th day if additional information is required.
- Decision within 1 work day once all information is received
- Maximum decision timeframe: 7 days from receipt of the request
- Notify requester by day 7 if more information is needed
Definitions
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