A doctor should respond to third party payor requests within 45 days via brief written summary.

• A. 15 days
• B. 30 days
• C. 45 days
• D. 90 days

Answer: (C)

Providing timely responses to third-party payor requests is about keeping the claims process moving and ensuring the insurer gets essential information without unnecessary delay. The rule requires a brief written summary to be provided within 45 days. This timeframe gives the clinician a reasonable window to review the case and prepare a concise, relevant summary, while avoiding the delays that a longer period could cause for patient access to benefits. Shorter deadlines like 15 or 30 days would be more burdensome and aren’t the standard set by the regulation, and a 90-day timeframe would unnecessarily delay the payer’s review. Therefore, the 45-day period is the correct mandated timeframe.