What does it mean if I receive a “PEND” notification when submitting a request on-line with iExchange®?
A “PEND” recommendation means that an approval could not be issued, because the request did not meet the guideline in which case there is a high likelihood of a denial, or there were errors or inconsistency on the request form. You may be called for clarification, and then final authorization determination will be made by the department. • Does the UR requirement apply to self-insurers or Crime Victims? No. SIE and Crime Victims, however, require prior authorization. For Self-Insured Claims, contact the self-insured employer (SIE) or the third party administrator (TPA) to request authorization. View a list of SIE/TPAs. For Crime Victims claims, request authorization for advanced imaging by contacting the program’s claim manager by phone at 800-762-3716 or fax at 360-902-5333. • Is Advanced Imaging UR required for in-patient admissions? No. Advanced Imaging done during an “approved” in-patient admission does not require a separate review. Review for the services will be part of the inpa
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- What does it mean if I receive a "PEND" notification when submitting a request on-line with iExchange?
