Prior Authorization Processing Timeframes Status

1. Prior Authorization Processing Timeframes Status Completed: • Increased staff dedicated to processing faxes by 12 to clear out unattached fax inventory • Increased CSR staff to manage ongoing incoming faxes • Increased clinical staff • Proactive outreach: 18 one on one sessions since 1/3 • Attached and reduced all outstanding hard copy faxes • Reduced inventory (all service types)

2. Prior Authorization Electronic Submission • Completed • Timing out when submitting PA - additional CPU added 1/16 • Reverse proxy error – technical changes resolved 1/16 • In Process • Continued stay capability – 2/20 • Character length in “notes” field – 2/20 • Release of information checkbox – to be removed 2/20 • Size limitation of file attachments at 4mgb – under evaluation

3. Prior Authorization Fax and Phone Access • Call Volume: • Dec (736/day) • Jan (626/day) • Jan 23 - 27th (605/day) • Abandonment Rate: • Dec (1.89%) • Jan 1 - 20th (9.30%) • Jan 23 - 27th (2.34%) • Calls answered in 60 seconds: Dec and Jan (94-98%) • Average wait time: Dec (16 seconds), Jan (7 seconds) • Fax busy: Dec (15%) to Jan (3%)

4. Prior Authorization Status Completed: • Last 6 months of Magellan data (pre 12/5) loaded In Process: • Ongoing research with individual facilities • Eliminating duplicate cases with multiple PA numbers for same dates of service or recipient

5. Provider Communication Completed: • Higher frequency of provider communications In Process: • Ongoing education and web messages to assist with; • definition of determinations, faxing tips, web submission tips • viewing and searching authorizations in portal • units available to show when claim is adjudicated • portal showing date of decision or rationale