Common use of Time Frames and Procedures for Expedited Service Authorization Decisions Clause in Contracts

Time Frames and Procedures for Expedited Service Authorization Decisions. For cases in which a Provider indicates, or the Contractor determines (on request from an Enrollee) that following the standard time frame could seriously jeopardize the Enrollee’s life or health or ability to attain, maintain, or regain maximum function, the Contractor shall:

Time Frames and Procedures for Expedited Service Authorization Decisions. (A) For cases in which a Provider indicates, or the Contractor determines (on request from an Enrollee) that following the standard time frame could seriously jeopardize the Enrollee’s life or health or ability to attain, maintain, or regain maximum function, the Contractor shall: (1) Make an expedited Service Authorization decision and provide notice as expeditiously as the Enrollee’s health condition requires, but no later than three working days after the receipt of the request for Service Authorization;