MedicaidAdministrativeMedium impact
BT2024131: IHCP reminds providers of administrative review requirements for fee-for-service prior authorization
Indiana Medicaid (IHCP)·IN·Prior Authorization
We identified it
Jun 19, 2026
Summary
IHCP reminds providers that administrative review requests for denied or partially approved fee-for-service prior authorizations must be submitted within 7 business days and clearly marked as 'administrative review' or 'reconsideration'. Requests must include specific documentation including the original PA form, medical records, and provider contact information.
Action Required
Immediately: Staff handling prior authorization denials must ensure all administrative review requests are submitted within 7 business days of receiving denial notification. Mark requests clearly as 'administrative review' or 'reconsideration'. Include original PA form (or summary with auth number, member name, IHCP ID), all supporting medical records, and provider contact information. Submit via fax, mail, or Atrezzo Provider Portal using 'Reconsideration' option.