Service Review and Authorization Timeframes. The Contractor shall make Prior Authorization determinations in a timely and consistent manner so that Enrollees with comparable medical needs receive comparable and consistent levels, amounts, and duration of services as supported by the Enrollee’s medical condition, records, and previous affirmative coverage decisions. Unless otherwise specified, the Contractor shall meet, and shall require Subcontractors to meet, the following timelines for conduct of Medical Necessity and service authorization reviews:
Appears in 4 contracts
Samples: finance.ky.gov, finance.ky.gov, www.bidnet.com
