Retroactive Prior Authorization Request (PAR) Process for Certain Hospital Outpatient Department (OPD) Services Rendered in the Emergency Department (ED) will Follow Expedited Process

While this process typically requires the submission of a PAR before the services are rendered, in some circumstances (for example, ED cases), obtaining prior authorization is not possible, given the timing of the emergency and conditions when service(s) cannot be delayed. To avoid unnecessary delays in beneficiary care, Noridian will accept and process retroactive submission(s) of PAR(s) for ED services, when such a PAR is submitted, within two (2) business days (excluding federal holidays and weekends) of the date of service. Noridian will apply the expedited process when conducting a medical record review and communicate a decision to the requester.

For more information on the prior authorization process, visit our Prior Authorization for Certain Hospital OPD Services Webpage.

            Last Updated Tue, 20 Oct 2020 17:46:27 +0000