Foundation Program Sites

Extenuating Circumstances around Pre-Authorization & Admission Notification

Identifies situations where obtaining a pre-authorization is extremely difficult if not impossible. Outlines practices to be followed by provider organizations and health plans when these situations arise so that claims will not be denied for lack of pre-authorization.

BPR Category
Prospective Review – Medical

Legislation Page
ESSB 5346

Legislative Section
Section 10 (1) (a) (i)