Changes to Service Authorization Timeframes Effective April 1, 2026
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
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.