Common use of Expedited Service Authorizations Clause in Contracts

Expedited Service Authorizations. a. If a request to authorize the services specified in the ISP includes a certification from any member of the Team that the Participant's life, health, or ability to attain, maintain, or regain maximum function would be placed in jeopardy by following the regular authorization process, the Contractor must notify the Participant or the Participant's representative, as appropriate, of the decision to approve or deny a request for services or to authorize a service in an amount, duration, or scope less than requested as expeditiously as the Participant's condition requires, at least orally, no later than seventy- two (72) hours after receiving the request for services unless additional information is needed. b. If no additional information is needed, the Contractor must mail or hand deliver written notice of the decision to the Participant or the Participant's representative, as appropriate; the Supports Coordinator; and the prescribing Provider, if the prescribing Provider is not a member of the Team, within two (2) business days after the decision is made. c. If additional information is needed to make a decision, the Contractor must request such information within one (1) business day of receiving the request and allow one (1) business day for submission of the additional information. i. If the requested information is provided within one (1) business day, the Contractor must make the decision to approve or deny the service and notify the Participant or the Participant's representative, as appropriate, of the decision orally within one (1) business day of receipt of the additional information. The Contractor must mail or hand deliver written notice of the decision to the Participant or the Participant's representative, as appropriate; the Supports Coordinator; and the prescribing Provider, if the prescribing Provider is not a member of the Team, within two (2) business days after the decision is made. ii. If the requested information is not received within one (1) business day, the Contractor must make the decision to approve or deny the service based upon the available information and notify the Participant or the Participant's representative, as appropriate, of the decision orally within one (1) business day after the additional information was to have been received. The Contractor must mail or hand deliver written notice of the decision to the Participant or the Participant's representative, as appropriate; the Supports Coordinator; and the prescribing Provider, if the prescribing Provider is not a member of the Team, within two (2) business days after the decision is made.

Expedited Service Authorizations. a. If a request to authorize the services specified in the ISP includes a certification from any member of the Team that the Participant's life, health, or ability to attain, maintain, or regain maximum function would be placed in jeopardy by following the regular authorization process, the Contractor must notify the Participant or the Participant's representative, as appropriate, of the decision to approve or deny a request for services or to authorize a service in an amount, duration, or scope less than requested as expeditiously as the Participant's condition requires, at least orally, no later than seventy- two (72) hours after receiving the request for services unless additional information is needed. b. If no additional information is needed, the Contractor must mail or hand deliver written notice of the decision to the Participant or the Participant's representative, as appropriate; the Supports Support Coordinator; and the prescribing Provider, if the prescribing Provider is not a member of the Team, within two (2) business days after the decision is made. c. If additional information is needed to make a decision, the Contractor must request such information within one one (1) business day of receiving the request and allow one (1) business day for submission of the additional information. i. If the requested information is provided within one one (1) business day, the Contractor must make the decision to approve or deny the service and notify the Participant or the Participant's representative, as appropriate, of the decision orally within one (1) business day days of receipt of the additional information. The Contractor must mail or hand deliver written notice of the decision to the Participant or the Participant's representative, as appropriate; the Supports Support Coordinator; and the prescribing Provider, if the prescribing Provider is not a member of the Team, within two (2) business days after the decision is made. ii. If the requested information is not received within one (1) business day, the Contractor must make the decision to approve or deny the service based upon the available information and notify the Participant or the Participant's representative, as appropriate, of the decision orally within one (1) business day days after the additional information was to have been received. The Contractor must mail or hand deliver written notice of the decision to the Participant or the Participant's representative, as appropriate; the Supports Support Coordinator; and the prescribing Provider, if the prescribing Provider is not a member of the Team, within two (2) business days after the decision is made.

Expedited Service Authorizations. a. If a request to authorize the services specified in the ISP includes a certification from any member of the Team that the Participant's life, health, or ability to attain, maintain, or regain maximum function would be placed in jeopardy by following the regular authorization process, the Contractor must notify the Participant or the Participant's representative, as appropriate, of the decision to approve or deny a request for services or to authorize a service in an amount, duration, or scope less than requested as expeditiously as the Participant's condition requires, at least orally, no later than seventy- two (72) hours after receiving the request for services unless additional information is needed. b. If no additional information is needed, the Contractor must mail or hand deliver written notice of the decision to the Participant or the Participant's representative, as appropriate; the Supports Support Coordinator; and the prescribing Provider, if the prescribing Provider is not a member of the Team, within two (2) business days after the decision is made. c. If additional information is needed to make a decision, the Contractor must request such information within one one (1) business day of receiving the request and allow one (1) business day for submission of the additional information. i. If the requested information is provided within one one (1) business day, the Contractor must make the decision to approve or deny the service and notify the Participant or the Participant's representative, as appropriate, of the decision orally within one (1) business day days of receipt of the additional information. The Contractor must mail or hand deliver written notice of the decision to the Participant or the Participant's representative, as appropriate; the Supports Support Coordinator; and the prescribing Provider, if the prescribing Provider is not a member of the Team, within two (2) business days after the decision is made. ii. If the requested information is not received within one (1) business day, the Contractor must make the decision to approve or deny the service based upon the available information and notify the Participant or the Participant's representative, as appropriate, of the decision orally within one (1) business day days after the additional information was to have been received. The Contractor must mail or hand deliver written notice of the decision to the Participant or the Participant's representative, as appropriate; the Supports Support Coordinator; and the prescribing Provider, if the prescribing Provider is not a member of the Team, within two (2) business days after the decision is made.

Expedited Service Authorizations. a. If a request to authorize the services specified in the Initial ISP or the FBA-Based ISP includes a certification from any member of the Team that the Participant's life, health, or ability to attain, maintain, or regain maximum function would be placed in jeopardy by following the regular authorization process, the Contractor must notify the Participant or the Participant's representative, as appropriate, of the decision to approve or deny a request for services or to authorize a service in an amount, duration, or scope less than requested as expeditiously as the Participant's condition requires, at least orally, no later than seventy- two three (723) hours business days after receiving the request for services unless additional information is needed. b. If no additional information is needed, the Contractor must mail or hand deliver written notice of the decision to the Participant or the Participant's representative, as appropriate; the Supports Support Coordinator; and the prescribing Provider, if the prescribing Provider is not a member of the Team, within two (2) business days after the decision is made. c. If additional information is needed to make a decision, the Contractor must request such information within one one (1) business day of receiving the request and allow one (1) business day for submission of the additional information. i. If the requested information is provided within one (1) business day, the Contractor must make the decision to approve or deny the service and notify the Participant or the Participant's representative, as appropriate, of the decision orally within one (1) business day days of receipt of the additional information. The Contractor must mail or hand deliver written notice of the decision to the Participant or the Participant's representative, as appropriate; the Supports Support Coordinator; and the prescribing Provider, if the prescribing Provider is not a member of the Team, within two (2) business days after the decision is made. ii. If the requested information is not received within one (1) business day, the Contractor must make the decision to approve or deny the service based upon the available information and notify the Participant or the Participant's representative, as appropriate, of the decision orally within one (1) business day days after the additional information was to have been received. The Contractor must mail or hand deliver written notice of the decision to the Participant or the Participant's representative, as appropriate; the Supports Support Coordinator; and the prescribing Provider, if the prescribing Provider is not a member of the Team, within two (2) business days after the decision is made.