Frequently asked questions about Prior Authorization Review
What do I need to send in for reconsideration?
A reconsideration request must be submitted within 35 calendar days from the date of the letter. If you disagree with the decision and you have further documentation to support admission/continuation, you may request reconsideration. A written request for reconsideration, a copy of the partial approval/denial letter, and additional supporting documentation must be submitted.
Where do I send the prior authorization/reconsideration request?
Prior Authorization/Reconsideration requests can be sent to:
124 West Capitol Avenue, Suite 900
Little Rock, AR 72201
866.321.5415
124 West Capitol Avenue, Suite 900
Little Rock, AR 72201
866.321.5415
Can I fax a prior authorization/reconsideration request?
We prefer that you mail them, but yes a prior authorization request can be faxed to Attn: Nancy Archer at 501.801.6901. However, our fax machine will not send a delivery notification. Also, please be sure to put the number of pages (including the cover sheet) that you are faxing so that it can be verified that all pages are received.
What if the Medicaid beneficiary’s name is misspelled on the authorization?
Please submit a request asking that the name be corrected. The request should include the child’s Medicaid number and the applicable Prior Authorization number.
What if the Medicaid beneficiary’s name is changed during an authorized date range?
Please submit a request asking that the name be corrected. The request should include the beneficiary’s Medicaid number, the applicable Prior Authorization number, and documentation supporting the legal change of the beneficiary’s name.
I sent in a PAR and have not heard anything back. How can I check to status of the request?
If you would like to check the status of a review, call Nancy Archer at 866-321-5415, and she will be happy to look it up for you. However, remember that we have 15 working days to complete a prior authorization request from the day that we receive it.
How long do I have to send in a prior authorization packet?
A packet cannot be reviewed 30 days before the Start of Care (SOC) date. For example: If you send in a packet on 10/01/10 with a SOC date of 12/01/10, we cannot review the chart until 11/01/10.
