Ohio – New Legislation Impacts Electronic Prior-Authorization Requests

January 2018 ~

As of January 1st, Ohio Senate Bill 129 (House Bill 505) now requires insurers to implement faster turn-around times for reviews of prior-authorizations (PA) that are submitted electronically.

Insurers are now required to respond to electronically submitted Urgent PA requests in 48 hours and to Non-Urgent PA requests in 10 calendar days.

Anthem states will use its current functionality to accept PA requests electronically via ICR (Interactive Care Reviewer). Providers can access the ICR through the Anthem’s Availty Web Portal. The insurer notes that this faster turn-around time also applies to the appeals process for an adverse PA decision.

 

 

Source(s): Anthem Blue Cross Blue Shield Network Update;

 

 

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