The purpose of this training is to educate, assist, and support Medicaid providers who submit prior authorization requests and Children with Special Health Care Needs (CSHCN) Services Program providers who submit authorization and prior authorization requests.

When it comes to prior authorizations, timing is everything. In this webinar, the following topics are discussed:

-In the Medicaid fee-for-service (FFS) section, we’ll identify general prior authorization guidelines and explain how retroactive eligibility can impact prior authorizations.
-In the CSHCN Services Program section, we’ll identify authorization and prior authorization guidelines that are unique to the CSHCN.
-Next, we have the PA Criteria section, which highlights the prior authorization criteria for FFS, CSHCN, and retroactive eligibility.
-Submission Methods will list the different methods for submitting prior authorization requests and submission best practices.
-PA on the Portal is the recommended submission method for prior authorization requests. In this section, we’ll show you how to access the portal and where you can view your requests that are in Pending Provider Response status.
-Finally, we’ll end the webinar with a list of the takeaways from today’s presentation, as well as a Q&A session.

Updates to programs, policies, and procedures discussed in this activity can be found on the TMHP website in the most currently published provider manuals and web articles.