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)