CSHCN Services Program 2010 > Authorizations and Prior Authorizations

Authorizations and Prior Authorizations

4.1 General Information 4-2

4.1.1 Limitations 4-2

4.1.2 Signature Requirements 4-2

4.1.3 Requests for Procedures That Are Pending a Rate Hearing 4-2

4.2 Authorizations 4-3

4.2.1 Services that Require Authorization 4-3

4.2.2 How To Submit an Authorization Request 4-5

4.3 Prior Authorizations 4-5

4.3.1 Services that Require Prior Authorization 4-5

4.3.2 Prior Authorization for Inpatient Admission After Business Hours 4-8

4.3.3 How to Submit a Prior Authorization Request 4-8

4.4 Extension of Filing Deadlines for Holidays 4-8

4.5 Specialty Team or Center Services 4-9

4.6 Authorization and Prior Authorization Denials 4-9

4.6.1 Administrative Review for Authorization and Prior Authorization Denials 4-10

4.6.2 Fair Hearing 4-10

4.7 TMHP-CSHCN Contact Center 4-11

4.8 Authorization and Filing Deadline Calendar for 2009 4-12

4.9 Authorization and Filing Deadline Calendar for 2010 4-13

4.10 Authorization and Filing Deadline Calendar for 2011 4-14