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If an enrollee or provider fails to obtain authorization prior to being seen in treatment, will CBHA backdate?

April 26, 2017Authorization backdate cbha enrollee fails obtain prior Provider seen treatment

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If an enrollee or provider fails to obtain authorization prior to being seen in treatment, will CBHA backdate?

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CBHA will not backdate if pre-authorization is not obtained prior to the provision of services. Failure to obtain prior authorization will result in an administration sanction which is a denial due to failure to follow the provider contract and is not related to medical necessity.