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    CAFFinance
    Guided decision tool

    My prior authorization is delayed or denied. What should I do next?

    Answer the questions your plan and provider will use to identify the process stage. The result explains who to call, what to ask, what to gather, and which official rules still need verification.

    Private by design

    Your answers stay in this browser session. They are not uploaded or included in analytics.

    Clinical urgency comes from the clinician

    The tool can raise an expedited-review question but cannot decide whether a case is medically urgent.

    The written notice controls

    Plan type, notice language, service type, and state or federal rules can change the pathway and deadline.

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    Coverage

    What coverage is handling this request?

    Why this matters: Appeal rights, decision windows, contacts, and written notices differ by coverage type.

    Educational only. This guide does not decide whether a service is medically necessary, covered, urgent, approved, appealable, or payable. Do not delay emergency care while using an insurance tool. For an immediate medical emergency, call 911 or seek emergency care.