Prior authorization timeframes
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This document sets the timelines Vns Health will follow to decide prior authorization requests (standard, concurrent, and inpatient-related), and who to contact for care team support. It applies to Vns Health prior authorization processes and affects providers submitting requests and members.
No material clinical or coverage changes in this revision.
Provider Timelines and Contacts
Retrospective / Pre‑service decision timeframe
For retrospective (pre‑service) prior authorization requests, Vns Health will decide within 3 calendar days after receiving all necessary information, and no more than 7 calendar days from receipt; if additional information is needed Vns Health will notify by day 7.
Concurrent decision timeframe
For concurrent review requests, Vns Health will decide within 1 calendar day after receiving all necessary information, and no more than 7 calendar days from receipt; if additional information is needed Vns Health will notify by day 7.
Inpatient (post‑admission rehab) decision timeframe
For inpatient post‑admission rehabilitation requests, Vns Health will decide within 1 calendar day after receiving all necessary information, and no more than 7 calendar days from receipt; if additional information is needed Vns Health will notify by day 7.
Contact information for provider/care teams
Providers or care teams may contact the Vns Health care team by phone at 1-888-867-6555 (TTY: 711), Monday–Friday, 9:00 AM–5:00 PM.
Definitions of Review Types and 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.