Common use of Amendment of Previous Authorizations for Outpatient Procedures Clause in Contracts

Amendment of Previous Authorizations for Outpatient Procedures. The contract must describe that the PHP shall accept retroactive requests for authorization of outpatient procedures in those instances where, in accordance with generally accepted North Carolina community practice standards and meeting the North Carolina Medicaid Medical Necessity Standard, an authorized outpatient procedure was modified or supplemented as a results of clinical findings or outcomes arising during the authorized outpatient procedure. Provider shall submit such retroactive requests for authorization within three (3) business days of concluding the authorized outpatient procedure.

Amendment of Previous Authorizations for Outpatient Procedures. The contract must describe that the PHP Partners shall accept retroactive requests for authorization of outpatient procedures in those instances where, in accordance with generally accepted North Carolina community practice standards and meeting the North Carolina Medicaid Medical Necessity Medically Necessary Standard, an authorized outpatient procedure was modified or supplemented as a results result of clinical findings or outcomes arising during the authorized outpatient procedure. Provider shall submit such retroactive requests for authorization within three (3) business days of concluding the authorized outpatient procedure.. (Attachment F.a.xxix.p.321-322)