23 CAR § 141-103. Medical provider office requirements for ACPA-approved teams

(a) For healthcare services that are recommended by a surgical member of a nationally approved cleft-craniofacial team, a request for written authorization shall be submitted to the health benefit plan at least: (1) Two (2) working days before the proposed service date, by a nationally approved cleft-craniofacial surgical team, for a nonurgent case; or (2) Twenty-four (24) hours before the proposed service date, by a nationally approved cleft-craniofacial surgical team member, for an urgent case. (b) Every needed service or recommended procedure shall be authorized by an attestation in the form established by this part that is signed by a surgical team member of an ACPA-approved team, and thereafter be monitored under the coordinated treatment plan until the completion of such services by the nationally approved cleft-craniofacial surgical team member. (c) The standards in this section shall follow the Prior Authorization Transparency Initiative.