Transparency Requirements
Pennsylvania Prior Authorization Requirements
A guide to prior authorization rules, turnaround times, and laws for medical practices operating in Pennsylvania (PA).
PA Turnaround Times
Standard Requests
15 business days
Urgent / Expedited
48 hours
Key Regulations
- Standard PA turnaround of 15 business days
- Urgent requests within 48 hours
- PA criteria available upon request
Pennsylvania Medicaid PA
Pennsylvania Medicaid (HealthChoices) uses managed care. PA administered by MCOs.
Top Payers in Pennsylvania
Independence Blue CrossHighmark Blue Cross Blue ShieldUPMC Health PlanAetnaGeisinger Health Plan
State Regulatory Body: Pennsylvania Insurance Department
File PA complaints or appeals through your state insurance department.
Automate PA in Pennsylvania
Greenlight knows every payer's PA requirements in Pennsylvania and checks them automatically before every appointment -- so your staff does not have to.
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