Peer-to-peer reviews for all authorization requests will follow new process by October 9
Effective Oct. 9, 2024, outpatient peer-to-peer reviews (P2P) will only consider the clinical information submitted with the initial authorization request. This update is in alignment with industry standards and with our updated inpatient P2P process, which goes into effect September 4.
We’ll classify any additional information submitted after the initial denial as a level 1 appeal and cancel the P2P request.
As a reminder, we offer two levels of appeal for medical authorization denials.
Get more information
Review our full P2P policy for additional information, including request timelines, when P2Ps aren’t available, how to request a P2P and more.