How is the consultant’s decision communicated?
Once a decision is made, a notice is sent to the provider through the provider’s preferred method of communication and a notice is mailed to the member. The notice advises both parties of the decision and the rationale for the decision. After the decision process is completed, photographs and X rays submitted with the request are returned to the provider. The PA unit does not retain copies of these items. When a PA is submitted via the Provider Online Service Center, the decision can be viewed via the same application. In this way, the provider is aware of the decision in advance of receiving notification via mail, if mail is the provider’s preferred method of communication.
