Statutes, codes, and regulations
Indiana Administrative Code
Title 405 - OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICESArticle 5 - MEDICAID SERVICES
Rule 405 IAC 5-7 - Administrative Review and Appeals of Prior Authorization Determinations
Section 405 IAC 5-7-2 - Provider requests for administrative review

405 Ind. Admin. Code 5-7-2

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Current through December 25, 2024
Section 405 IAC 5-7-2 - Provider requests for administrative review

Authority: IC 12-15-1-10; IC 12-15-1-15; IC 12-15-21-2

Affected: IC 12-13-7-3; IC 12-15

Sec. 2.

(a) A provider authorized to submit prior authorization requests who wishes review of denial or modification of a prior authorization decision must request an administrative review before filing an appeal under 405 IAC 1.1.
(b) An administrative review request must be initiated within seven (7) working days of the receipt of modification or denial by the provider who submitted the prior authorization request. The request shall be submitted in writing to the office; telephonic requests will not be accepted.

405 IAC 5-7-2

Office of the Secretary of Family and Social Services; 405 IAC 5-7-2; filed Jul 25, 1997, 4:00 p.m.: 20 IR 3309; readopted filed Jun 27, 2001, 9:40 a.m.: 24 IR 3822; readopted filed Sep 19, 2007, 12:16p.m.: 20071010-IR-405070311RFA; readopted filed Oct 28, 2013, 3:18 p.m.: 20131127-IR-405130241RFA
Filed 8/1/2016, 3:44 p.m.: 20160831-IR-405150418FRA
Errata filed 11/1/2016, 9:36 a.m.: 20161109-IR-405160493ACA
Readopted filed 7/28/2022, 2:21 p.m.: 20220824-IR-405220205RFA
Readopted filed 5/30/2023, 11:54 a.m.: 20230628-IR-405230292RFA