Simplify Compliance with 7 AAC 120.410 and § 21.07.020Using Banjo Health
In Alaska, prior authorization (PA)regulations are clearly defined—but operationalizing them can create real workflow bottlenecks for payers and PBMs. Governed by 7 AAC 120.410 and Alaska Stat. § 21.07.020, these rules set expectations for timeliness, review integrity, and provider accessibility, especially for Medicaid and emergency-related care.
Banjo Health helps you comply with Alaska’s requirements effortlessly—delivering intelligent automation, real-time decisioning, and audit-ready workflows for medical and pharmacy PA.
PA Timelines in Alaska
Alaska's law prioritizes fast, transparent decision-making:
● Non-Emergency Requests: Must be processed within 72 hours
● Post-Emergency Services: Must be reviewed within 24 hours after stabilization
Manual systems often struggle to keep up. Banjo Health’s urgency-aware platform automatically triages requests, aligns them with Alaska’s required turnaround times, and eliminates delays caused by human error or workload spikes.
Documentation & Submission Requirements
Alaska requires complete, accurate information for any PA determination. While there’s no mandated ePA standard yet, health plans are expected to accept digital submissions and offer clear, timely communication to providers.
Banjo Health supports:
● NCPDP SCRIPT standard for ePA
● Secure digital provider portals
● Automated intake validation to ensure all necessary documentation is present
This means less provider back-and-forth—and more first-pass approvals.
Who Reviews PAs in Alaska?
State regulations require that denials and appeals be reviewed by:
● A licensed healthcare provider, and
● One whose scope of practice matches that of the requesting provider (e.g., a physician reviewing a physician’s request)
Banjo automatically routes denials and escalations to clinically appropriate reviewers, ensuring full compliance with Alaska's peer review and appeal requirements—while improving decision quality.
Provider Access Requirements
In Alaska, providers must have 24/7 access to a representative for post-emergency care and follow-up authorizations.
Banjo’s platform enables:
● Real-time chat and callback requests
● Status tracking portals
● Secure upload of supporting clinical documentation
You give providers what they want—faster answers and less friction—while staying compliant with Alaska’s transparency rules.
Retrospective Denials and Appeals
Alaska prohibits retroactive denials unless the information provided was incomplete or inaccurate. Plans must ensure internal review processes are fair, fast, and clearly documented.
Banjo keeps a permanent audit log of every submission, approval, appeal, and peer interaction—so your team always has proof of compliance and accountability.
Banjo Health: Your PA Compliance Engine for Alaska
Alaska’s rules are clear—but compliancerequires discipline. With Banjo Health, payers and PBMs in Alaska can automatethe complexity, stay ahead of deadlines, and improve the provider experience atthe same time.
✅Automated timing rules (24/72 hours)
✅ Peer-to-peer clinical reviewautomation
✅ Secure digital intake and ePA support
✅ Transparency and provider communications tools
✅ Fully auditable logs for Medicaid and commercial plans
