The countdown has begun.
Starting January 1, 2026, the Centers for Medicare & Medicaid Services (CMS) is reducing the pre-service prior authorization timeframe from 14 days to just 7. That means health plans and systems must issue translated, member-facing critical communications within 7 calendar days of a prior authorization request. No exceptions, no extensions.
Under the rule, it’s not enough to make a fast decision; you must also deliver an accurate, compliant translation that’s a mirror image of the English original, and delivered to your members, on time and under budget.
For most organizations, the challenge isn’t making the decision. It’s managing the processes, documentation, and especially a translation workflow with an external supplier.
The Real Bottleneck: Translation, Not Authorization
Let’s be honest: legacy translation models weren’t built for this kind of pressure. Most rely on manual intake, slow file handoffs, and antiquated QA processes.
Here’s how it still looks at many organizations:
• Files are emailed to vendors, often as PDFs
• Translators struggle with file conversion and rekeying content
• Formatting gets lost, files get corrupted
• QA is tracked manually across email threads or Excel sheets
• Final documents are returned with a risk to version control
This might work under a 14-day window. But with just 7 calendar days, including weekends and holidays, it’s a risk you can’t afford.
The BIG Fix: Smarter Translation Workflows, Built for Regulatory Pressure
Translation isn’t just a checkbox. It’s a vital part of how plans meet regulatory obligations and communicate clearly with members. The new CMS rule makes that explicit: translated notices must be complete, accurate, timely, and traceable.
At BIG Language Solutions, we’ve built workflows that help health plans and systems get there with translation solutions that are faster, more secure, and purpose-built for high-stakes communication. Our approach combines two workflows that work together to meet CMS’s 7-day rule with confidence:
LanguageNow™ — Accelerates Variable Content
For authorization notices that include member-specific information, LanguageNow™ delivers near real-time translation without sacrificing quality or control.
• Powered by custom NMT engines inside our secure LanguageVault™ platform
• Supports client-specific glossaries, style rules, and translation memory
• Automatically flags low-confidence segments for post-editing
• Fully encrypted and compliant with PHI and PII regulations
• Delivers accurate, formatted content in minutes
LanguageNow™ is ideal for variable, member-specific notices that need speed, sensitivity, and scale.
LanguageExpress™ — Streamlines the Rest
For templated documents, critical communications, and high-volume quick-twitch programs, our proprietary tech-enabled workflow, LanguageExpress™, keeps things moving with a conveyor-belt-style workflow.
• Processes thousands of files per day, 24/7
• Connects directly with your systems via API to consume content dynamically
• Automates QA checks, formatting, and delivery
• Supports all required output types (XML, large print, Braille, etc.)
• Tracks every step with full audit trails, logs, and performance data
Together, LanguageNow™ and LanguageExpress™ ensure your member-specific, critical communications are translated, formatted, and delivered on time, every time.
This is not just translation. It’s a workflow solution, purpose-built for compliance-heavy regulated environments like healthcare.
Compliance, Control, and Confidence Built In
CMS isn’t just enforcing tighter timelines; they’re raising the bar on oversight.
LanguageNow™ and LanguageExpress™ help you stay ready for any audit, grievance, or regulatory review.
You get:
• Fully traceable workflows
• Role-based access control
• End-to-end encryption
• Proof of compliance at every stage
From intake to delivery, every file is tracked, timestamped, and secured.
Proven at Scale
BIG’s language platforms are already helping national and regional payors:
• Cut translation turnaround from days to just hours
• Expand coverage across dozens of required languages
• Reduce spend on repetitive QA and formatting tasks
• Prepare for CMS audits with built-in reporting and data exports
Whether you send 100 letters a month or 10,000, our system scales with you. And because it’s modular, we can plug into your existing workflows without disruption.
Are You Ready for January 1?
CMS isn’t just tightening timelines; they’re raising the bar on accountability. And for most health plans, that means rethinking how translated notices are created, delivered, and tracked.
If your current process relies on manual handoffs, fragmented QA, or overnight email chains, it won’t hold up under the 7-day rule.
With LanguageNow™ and LanguageExpress™, you get a workflow designed for what’s next:
• Faster turnaround
• Stronger compliance
• Full traceability
• Audit readiness by default
Don’t let translation be the weak link in your compliance chain. Let’s future-proof your workflow before the deadline hits.
Request a demo with our team.
