Prior Auth Required

56000 - 22 CCR § (2); 28 CCR §1300.67.2.2  

This procedure appears on the selected insurer prior authorization source.

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Prior authorizationPrior Auth Required
Procedure / Service22 CCR § (2); 28 CCR §1300.67.2.2  
Procedure / Service Description

C. Health care services are readily available. - Site Office Management Survey Criteria (Continued) Yes No N/A wt C. Health care services are readily available. 22 CCR §56000(2); 28 CCR §1300.67.2.2   1. Appointments are scheduled according to patients stated clinical needs within the timeliness standards established for Plan members. 1

Likely documents
  • Confirm benefit details
  • Submit clinical notes if requested by the plan
Next actions
  • Confirm the current plan policy before submission.
  • Use the insurer authorization workflow for this listed code.