NJ Admin Code § 11:24-8.3(c)(1)(ii)

October 15, 2021 5:25 am | Published by

(c) All determinations shall be made on a timely basis, as required by the exigencies of the situation.

(1) An HMO shall notify a provider and/or member of a determination concerning:

(ii) A non-urgent pre-service (that is, prior authorization) no later than 15 days after receipt of the pre-service claim by the HMO

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