Medical Service, Equipment and Supply Service Authorization Timely Determination Rate: New Routine Requests

Percent of medical service, equipment, and supply service authorization determinations made within 14 calendar days after receipt of request for new routine requests made during the measurement period. Exclude authorization requests that extend beyond the 14-day period due to the following:

  • The member requests an extension, or
  • The MCO justifies a need for additional information and the extension is in the member's interest.

Exclude requests for non-emergency medical transportation from this measure.

Measure Identifier: SERVICEAUTH.03

Please see Report Details below for more information on selected subgroups, organizations, and aggregation.