What is the timeframe allowed by APS Healthcare for submitting requests for prior authorization?
Processing Timelines for Requests For consideration for prior authorization, a request must be processed within 10 calendar days of the requested start date of the service. Even though a provider may submit a request to the APS Web site or transfer an EDI file to the ftp site at any time as access to the sites is generally available 24 hours a day, requests for prior authorization are processed only on regular business days. Requests are not processed on weekends or holidays observed by APS – West Virginia. For a list of these holidays and when they will be observed please contact APS. More specifically, for a request to be processed on a regular business day the request must be received by 3 p.m. through the EDI process and by 5 p.m. through the direct data entry Web site on that business day. The EDI files submitted to APS are evaluated/validated before processing, thus the 3 p.m. daily deadline is in place. Requests Requiring Additional Information If a request for prior authorizati
