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CAQH CORE approves 2-day limit for health plans to act on prior authorizations

February 4, 2020

Fierce Healthcare LogoA group that represents multiple industry stakeholders has voted to set a two-day time limit on how quickly health plans must act on prior authorizations.

CAQH CORE, a group that includes 110 organizations representing health plans, providers, vendors and government entities, voted to set a two-day limit on how quickly health plans must request additional supporting information from providers and make final decisions on prior authorization requests, the group said in an announcement.

The prior authorization process is a frustrating one for physicians and other providers. In a recent WEDI survey, 84% of providers reported the number of medical services that require prior authorization has increased.

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