Approvals do not require an assessment, but one should be conducted if the IDT believes it will deny or partially deny a request.
An SDR is considered finalized when the participant is provided with notification of the decision. For an Approval, the notification may be verbal, written or both.
Verbal notifications must be documented in the medical record to the same standard as a written notification. Thus, all documentation of approval notifications (verbal or written) must include:
- An estimated timeline of when the participant should receive the service
- Any conditions of approval before the service will be provided (example: The IDT authorizes a dental bridge to be provided if the OMFS agrees it is needed).