Service Authorization Timeframes
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Defines the required decision timeframes for prior authorization and concurrent review requests and applies to Independent Health members and providers; updates member handbook effective April 1, 2026.
Standard prior authorization decisions will be made within 3 work days of having all necessary information, but no later than 7 days after receipt; members/providers will be notified by day 7 if more information is needed.
Standard concurrent review decisions will be made within 1 work day of having all necessary information, but no later than 7 days after receipt; notification by day 7 if more information is needed.
Inpatient rehabilitation requests after an inpatient admission will be decided within 1 work day of having all necessary information, but no later than 7 days after receipt.
Required Decision Timeframes and Provider Notifications
Prior Authorization Timeframe
Prior authorization requests: We will make a decision within 3 work days of when we have all the information we need, but no later than 7 days after we receive your request. We will tell you by the 7th day if we need more information.
- Target: 3 work days once information is complete
- Maximum: 7 calendar days from receipt
- Provider notification by day 7 if additional information is required
Concurrent Review Timeframe
Concurrent review requests: We will make a decision within 1 work day of when we have all the information we need, but no later than 7 days after we receive your request. We will tell you by the 7th day if we need more information.
- Target: 1 work day once information is complete
- Maximum: 7 calendar days from receipt
- Provider notification by day 7 if additional information is required
Inpatient Rehabilitation (post-admission)
Inpatient rehabilitation requests submitted post-admission: We will make a decision within 1 work day of when we have all the information we need, but no later than 7 days after we receive your request. We will tell you by the 7th day if we need more information.
- Applies when requesting inpatient rehabilitation after an inpatient hospital admission
- Target: 1 work day once information is complete
- Maximum: 7 calendar days from receipt
- Provider notification by day 7 if additional information is required
Service Authorization Timeframe Definitions
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