Pursuant to Section 4. 11.1, the Contractor shall submit Prior Authorization and Pre-Certification Reports that summarize all requests in the preceding quarter for Prior Authorization and Pre-Certification. The Report shall include, at a minimum, the following information: · Total number of completed requests for Standard Service Authorizations; · Total number of completed requests for Expedited Service Authorizations; · Percent of completed requests within timeliness standards by type of service; · Total number of completed requests authorized by type of service; · Total number or completed requests denied by type of service; and · Percent of completed requests denied by type of service; · Patterns and aggregate trend analysis
Appears in 4 contracts
Samples: Contract for Provision of Services (Wellcare Health Plans, Inc.), Contract (Centene Corp), Contract for Provision of Services (Centene Corp)
Pursuant to Section 4. 11.1, the Contractor shall submit Prior Authorization and Pre-Certification Reports that summarize all requests in the preceding quarter for Prior Authorization and Pre-Certification. The Report shall include, at a minimum, the following information: · • Total number of completed requests for Standard Service Authorizations; · • Total number of completed requests for Expedited Service Authorizations; · • Percent of completed requests within timeliness standards by type of service; · • Total number of completed requests authorized by type of service; · • Total number or completed requests denied by type of service; and · • Percent of completed requests denied by type of service; · • Patterns and aggregate trend analysis
Appears in 1 contract
Samples: Contract for Provision of Services
