Timelines for Decision-Making (by Line of Business)
Medicare
Commercial
Medicare
Urgent Request
72 hours from the receipt of request*
Non-Urgent Pre-Service Request
14 calendar days*
*Under specific circumstances, timeline may be extended an additional 14 calendar days.
To view a matrix with detailed information about the above timelines, extensions, and to learn about other authorization timelines, click below.
Medi-Cal
Commercial
Medicare
Urgent/Expedited Request
72 hours from the receipt of request.*
Routine Request
Within 5 working days of receipt of necessary information to make a decision but no later than 14 calendar days from the receipt of request.*
Retrospective Review
Within 30 calendar days from receipt of request.
* Under specific circumstances, timeline may be extended an additional 14 calendar days.
To view a matrix with detailed information about the above timelines, extensions, and to learn about other authorization timelines, click below.
Commercial
Commercial
Commercial
Urgent Request
72 hours from the receipt of request.
Non-Urgent Pre-Service Request
Within 5 business days from the receipt of request.
Post Service Request
Within 30 calendar days from the receipt of request.
To view a matrix with detailed information about the above timelines and to learn about other authorization timelines, click below.