As you begin the first step of submitting an authorization, it is important to consider the different processing times for your requests, based on the type of request submitted. Here are the four different types:
- Standard request: This is all non-urgent or emergent requests. These are processed within 14 days from the day received.
- Scheduled request: This is a request for an upcoming appointment that falls within the standard processing time frame above.
- Retroactive or post-service request: This is a service or appointment that has already taken place. These authorizations can take up to 30 days to process.
- Expedited request: This can also be defined as urgent or emergent. An expedited request must include documentation that demonstrates a need for the expedited time frame as being provider supported. The processing time depends on the plan:
- Samaritan Advantage: 72 hours
- Samaritan Choice: 72 hours
- InterCommunity Health Network CCO: 3 business days
- Samaritan Employer Group: 24 hours.
New! Request an authorization electronically
Our new Prior Authorization Wizard gives you a more convenient way to submit and track your authorizations. Access the online tool by logging on to ProviderConnect.
Authorization forms can be found on our Resources and Tools page.
Ensure your expedited requests meet qualifications
For a request to be considered expedited, the member, their authorized representative or the provider should believe that waiting the standard 14-day time frame would seriously jeopardize any of the following:
- The member’s life;
- Physical or mental health;
- The member’s ability to attain, maintain or regain maximum function;
- The member would be subjected to severe pain that cannot be adequately managed without the care or treatment that is the subject of the request.
What to do if you need to make changes to an existing authorization
If changes are needed to an existing authorization (e.g., procedure code or facility change), submit the needed change on a prior authorization form or approved authorization print out referencing the current authorization number. Changes can take up to the standard 14-day processing time, unless scheduled or expedited processing is indicated.
Check the status of your request online
Go to your provider portal at ProviderConnect.samhealth.org to view the status of your request. You may experience delays in your ability to view the status of an authorization until a decision is issued. Please note that this delay does not mean we have not received your request.