Prior authorization timeframes
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This document governs Vns Health's timelines for processing prior authorization requests and who to contact; it affects members and providers submitting prior authorization requests to Vns Health.
No material clinical or coverage changes in this revision.
Prior Authorization Processing Timeframes
prior authorization processing timeframes
Timeframe rules for prior authorization requests:
Provider Timelines and Actions for Prior Authorization
Standard prior authorization decision timeframe
For standard (non-urgent) prior authorizations, Vns Health will decide within 3 business days after receiving all necessary information; after the decision, the requester will be notified within up to 7 calendar days.
Concurrent (timely) prior authorization decision timeframe
For concurrent (timely) reviews, Vns Health will decide within 1 business day after receiving all necessary information; requester notification may occur within up to 7 calendar days after the decision.
Inpatient-related prior authorization decision timeframe
For requests related to inpatient stays (for example, inpatient rehabilitation), Vns Health will decide within 1 business day after receiving all necessary information; requester notification may occur within up to 7 calendar days after the decision.
- For assistance, contact Customer Service: 1-888-867-6555 (TTY: 711), Monday–Friday, 9:00 AM–5:00 PM.
Decision and Notification Timeframes
OpenPayer is powered by Trek Health's payer performance platform. Trek continuously ingests, validates, and normalizes Transparency in Coverage data alongside payer policies and other commercial payer data to create a structured payer intelligence foundation. OpenPayer uses this foundation to deliver personalized search results, dynamically generated policy pages, and tailored policy monitoring based on each user's payers, specialties, billing codes, and areas of interest. The same intelligence powers broader payer performance workflows, including reimbursement benchmarking, contract evaluation, payer negotiations, and financial decision-making.