Retrospective Authorizations

Retrospective reviews are accepted up to 60 days retro to the date of service. Request submitted beyond the 60 day timeframe, will receive contact from YCCO and the request will be withdrawn. YCCO will consider rendering a UM review depending on the circumstances that caused the retro submission.

A retrospective review is only accepted when no decision has taken place, including a claim decision, this includes a claim denied for no prior authorization. If a denial has taken place the member appeal process must be used to appeal the decision.