Regulatory Requirements

Prior Authorization Reporting

In an effort to improve transparency in the pre-authorization approval and decline
rates by health plans, Delaware law (Title 18, Subchapter V of the Delaware
Code) now requires the submission of prior authorization data to Delaware Health
Information Network (DHIN) at least twice a year.

Health insurers, health benefit plans and health service corporations are
required to report to DHIN de-identified statistics regarding pre-authorization
approvals, denials and appeals in the specified format [linked below] by January 31st and July 31st of each calendar year. 

Q&A from conference call with DHIN and the Department of Insurance (1/31/18)

Pre-authorization reporting requirements and reporting spreadsheet

Testimonials

“The information on DHIN is so helpful to our practice. We have patients come into the office that can’t remember where they had lab/radiology work done. Utilizing the DHIN system, we log onto DHIN, type in the patient’s name and we can see where the patient had reports done. It really does help us from having to call around and track down that information.”

– Debbie McGinnes, Nurse – Bijan Sorouri, MD, PA

Delaware Health Information Network - Empowering Data-Driven Decisions

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