RXMP-33 Oncology Service Date Revisions (backdating) Form

Oncology Service Date Revisions (Backdating)

Updated on: 9/11/2025

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Policy Number RXMP-33 Line of Business Medicaid & Medicare Effective Date 1/1/2026 Revision Date 9/11/2025

Description Service date revisions (backdating) of prior authorizations are approved by AlohaCare’s discretion. AlohaCare will adopt Optum’s standard service date revision policy allows for certain circumstances where a provider may call Optum CSO team and have the prior authorization “backdated”.
Standard Handling Process Allow for revisions more than 30 days after start of treatment BUT member must still be under care (or else this would fall under a retrospective review and not part of standard process).

Service date revisions can be made up to 30 days after the start of treatment. There are 3 justifications upon which we can do a service date revision":

1. Natural Disaster
2. System Outage

3. Provider can demonstrate that they received misinformation from the system, from MedOnc or from AlohaCare on whether a prior authorization was required.

   The Optum team will notify AlohaCare Pharmacy staff, if there is a need to backdate. This will not be made available to providers.

   Review History: Updated on: 9/11/2025