Prior Authorization File amp Submission Specifications 2026

1. Click ‘Get Form’ to open the Prior Authorization File & Submission Specifications in the editor.
2. Begin by reviewing the Introduction section, which outlines the requirements for managed care plans (MCPs) regarding prior authorization decisions.
3. Navigate to the Secure File Transfer Protocol section to understand how to securely submit your files. Ensure you have access to HSAG’s secure FTP site for file transfers.
4. Fill out the bi-weekly PA file layout by entering required data fields such as MMIS Billing Number, Service Type of Authorization Request, and Date of Request. Use tildes (~) where no data is available.
5. For each decision made, ensure you select the correct Approval/Limited Approval/Denial code and provide a narrative if applicable. This information is crucial for accurate reporting.
6. Once completed, save your document and utilize our platform's features to export or share it directly from Google Workspace for seamless integration into your workflow.

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