Service Authorization Request definition

Service Authorization Request means a Provider’s or Enrollee’s request to the Contractor for the provision of a service.

Service Authorization Request means a member’s initial or continuing request for the provision of a service including member requests made by their provider or the member’s authorized representative.

Service Authorization Request means a Provider’s or Enrollee’s request to the Contractor for the provision of a service. State Fiscal Year means twelve calendar months commencing on July 1 and ending on June 30 following or the 12-month period for which the State budgets funds. State Health Care Program means (1) a State plan approved under Title XIX of the Social Security Act, (2) any program receiving funds under Title V of the Social Security Act or from an allotment to a State under such title; (3) any program receiving funds under Title XX of the Social Security Act or from an allotment to a State under such title; or (4) a State child health plan approved under Title XXI of the Social Security Act. State Match means the current percentage of the state of Utah’s share of Medicaid expenditures as described by 42 CFR 433.10.

Examples of Service Authorization Request in a sentence

• Fourteen (14) days after receipt of request for Service Authorization Request.

• If the Contractor denies a Service Authorization Request, or authorizes a requested service in an amount, duration or scope that is less than requested, the Contractor shall make the decision and give a Notice of Action to the Enrollee as expeditiously as the Enrollee’s health condition requires it, but no later than 14 calendar days from receipt of the request for Service Authorization.

• If the Contractor denies a Service Authorization Request, or authorizes a requested service in an amount, duration or scope that is less than requested, the Contractor shall make the decision and give a Notice of Adverse Benefit Determination to the Enrollee as expeditiously as the Enrollee’s health condition requires it, but no later than 14 calendar days from receipt of the request for Service Authorization.

• Under this section, the Contractor may require as a condition of coverage or payment for a covered outpatient drug, for which Federal Financial Participation is available, the approval of the drug before its dispensing for any medically accepted indication only if the system providing for such approval provides response by telephone or other telecommunication device within 24 hours of a Service Authorization Request.

• Contractor shall notify the requesting Provider, in writing or orally, when Contractor denies a request to authorize a Covered Service or when the Service Authorization Request is in an amount, duration, or scope that is less than requested.

More Definitions of Service Authorization Request

Service Authorization Request means a request for the provision of a service, including prior authorization and concurrent review, that requires authorization pursuant to 42 CFR 438.210.

Service Authorization Request means a request by an Enrollee, or by a Provider on behalf of an Enrollee, for the provision of a Covered Service.

Service Authorization Request. A managed care member’s request for the provision of a service.

Service Authorization Request means a managed care member’s request for the provision of a service to the County. Skilled Nursing Care: Medically necessary skilled nursing services ordered by and to be administered under the direction of a physician that may only be provided by an advanced practice nurse, a registered nurse (RN), or a licensed practical nurse (LPN) working under the supervision of an RN.

Service Authorization Request means a member's initial or continuing request for the provision of a service including member requests made by their provider or the member's authorized representative.¶ (24765) "Type A Hospital" means a hospital identified by the Office of Rural Health as a Type A hospital.¶ (24866) "Type B AAA" means an AAA administered by a unit or combination of units of general purpose local government for overseeing Medicaid, financial and adult protective services, and regulatory programs for the elderly or the elderly and disabled.¶

Service Authorization Request has the meaning provided for in OAR 410-120-0000.

Service Authorization Request means a request by an Enrollee for the provision of a medical service.