Service Authorization definition

Service Authorization means that Open Ecosystem Partner needs to meet specific qualification requirements for the products included in a “Service” Product Family that Open Ecosystem Partner wants to promote and offer Services for as set out in detail in the Open Ecosystem Program Guide.

Service Authorization means a managed care Enrollee’s request, or a Provider’s request on behalf of an Enrollee, for the provision of services, and the MCO’s determination of the Medical Necessity for the medical service prior to the delivery or payment of the service.

Service Authorization means that Partner needs to meet specific qualification requirements for the products included in a “Service” Product Family that Partner wants to promote and offer Services for as set out in detail in the PartnerEdge Program Guide and the applicable RSPI.

Examples of Service Authorization in a sentence

• Contractor shall notify all Members who have undergone HRSN Eligibility Screening of the HRSN Service authorization or denial as expeditiously as the circumstances require, not to exceed fourteen (14) days from the date of, receiving the HRSN Request aligned with OAR 000-000-0000 and OAR 410-120-2020.

• Service authorization requests and claim payments that are denied for reasons other than lack of medical necessity and for which no clinical review was completed by the MCO are not subject to external medical review.

• Contractor shall notify all Members who have undergone HRSN Eligibility Screening of the HRSN Service authorization or denial as expeditiously as the circumstances require, not to exceed fourteen (14) days from the date of, receiving the HRSN Request aligned with OAR 410-141-3835 and OAR 410-120-2020.

More Definitions of Service Authorization

Service Authorization means the process of service necessity determination and service authori- zation of scope, amount and duration by the review organization.

Service Authorization means the process of determining service necessity and the level of care and number of units of service to be provided to a child.

Service Authorization. A Member’s request for the provision of a service.

Service Authorization. A managed care Member’s request for the provision of services

Service Authorization means a process through which a request for provisional approval of coverage is submitted to the Contractor or the Department for review.

Service Authorization means an authorization by CDDP of the DD Services that CDDP is responsible to authorize according to Exhibit B Part 2, as identified in an Individual’s ISP, and entered for billing purposes into eXPRS via POC or a CPA.

Service Authorization means the approval required from the designated authority for reimbursement for certain Medicaid services.