interqual criteria inpatient admission

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interqual criteria inpatient admission

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Inpatient behavioral health presentation slides – Mississippi Division …

Nov 17, 2015 … inpatient admission dates of service on or after Dec. … 2015 and June 30, 2016,
based on the Centers for Medicare and Medicaid …. InterQual appropriateness
criteria are developed by specialists representing a national.

MississippiCAN Hospital Inpatient Transition – Mississippi Division of …

Oct 26, 2015 … inpatient admission dates of service on or after Dec. … 2015 and June 30, 2016,
based on the Centers for Medicare and Medicaid ….. Magnolia has adopted
utilization review criteria developed by McKesson InterQual®.

FAQs: Two-Midnight Short-Stay Reviews – KePRO

Oct 1, 2015 … attempt to exclude inpatient admissions with an Inpatient …. InterQual® criteria is
outside of KEPRO's scope of work. 22. Are you saying that a …

UR Standards – Kentucky Hospital Association

On hold right now and in proposed 2016 IPPS CMS states considering …
InterQual criteria if possible (many private insurers use, others use … inpatient
admissions were medically necessary …. CMS Guidance on Hospital Inpatient
Admissions.

Chapter 13: Inpatient Hospital Notification and Authorization

Revised 1/06/2016. 1. Chapter 13 …. require inpatient hospital admission
notification within the first 24 hours regardless if a Service …. InterQual®
discharge criteria and, if necessary, secondary medical review, will be used to
determine if.

Care Management – e-Referral – BCBSM.com

2016. Care Management. BCN Provider Manual. Contents. Hyperlinks to
important information . …. Guidelines for observations and inpatient hospital
admissions . …… The acceptability of any existing criteria, such as InterQual®
criteria,.

LTAC summarized admission criteria – Emory Healthcare

POLICY: Long Term Acute Care (LTAC) Admission Criteria. RESPONSIBLE …
Decisions as to whether a patient meets inpatient criteria are based, though not
limited to, Interqual guidelines or other similar guidelines utilized by commercial …

Issue 4: July – August 2015 – HealthPlus of Michigan

Aug 31, 2015 … inpatient admission criteria . …. McKesson InterQual® 2015 Level of Care ….
2015, and what is predicted for the rest of 2015 and into 2016.

Download Chapter PDF – EmblemHealth

Dec 26, 2013 … … Provider Manual. Last Updated: 01/07/2016. 308 ….. Elective Inpatient
Procedures – Admitting Physicians. Elective Admission ….. For clinical decision
making, we utilize nationally recognized criteria (including InterQual) and.

Questions and Answers for Alabama Medicaid Agency Inpatient …

Sep 24, 2013 … There were 113,246 inpatient admissions in fiscal year 2012. What is the …. it
plans to begin utilizing InterQual®. Criteria? Alabama Medicaid Agency
Response: No. Page 26 …. Organizations starting in 2016 impact the.

Provider In-Service Presentation TX MMP – Cigna

Mar 1, 2015 … If a Member is admitted to an inpatient facility, Utilization Review nurses obtain
initial … medical necessity using InterQual criteria. CMS benefit …

Provider Orientation Presentation – New Hampshire Healthy Families

Medical: 2016. Carved. Out. Maternity & New Born. Outpatient Hospital. Inpatient
Psychiatric Facility Services Under Age 22. Physician ….. Inpatient Admission:
877-291-3140 … New Hampshire Healthy Families utilizes InterQual® Criteria.

Jessica Gustafson and Abby Pendleton

KEY PROVISIONS OF 2016 OPPS PROPOSED RULE … Frequently Asked
Questions, 2 Midnight Inpatient Admission Guidance & Patient Status … criteria
should be. … Will use commercial screening tool (InterQual) for initial screening.

table of contents – Utah Medicaid – Utah.gov

Jul 1, 2015 … INTERQUAL CRITERIA CHANGE FOR GYNECOLOGICAL …. CODING FOR THE
APPLICATION OF FLUORIDE VARNISH AND E&M ….. Beginning in 2016,
providers applying to become new Medicaid providers will enroll online. Current
…. including phone numbers to call for prior authorization of inpatient.

Fillable Online Acute Inpatient Fax Assessment Form (PDF) – Blue …

RESET Acute Inpatient Fax Assessment Form R InterQual O criteria MET R … to
AcutePrecertification1@bcbsm.com Include hospital admission H&P and PM&R …

Annual Report – Medicaid

2016. AHS and DVHA have been working closely with Vermont's Medicaid …..
Activity III: Numerator information and criteria should not be included in the …..
this strategy with documented reduction of ACS inpatient admissions by 37%, 30-
day …. Behavioral Health Team adopted the McKesson/Interqual tool for
authorizing.

TCH – University of Virginia

Jun 11, 2015 … B. Action Item: Fiscal Year 2016 Operating and. Capital Budgets … During this
same period, inpatient …. frequently based upon stricter criteria for admissions. ….
McKesson's Long-Term Acute Care Hospital (LTACH) Interqual.

Provider Update: News for the Network – Tufts Health Plan

Aug 1, 2015 … The Scar Contracture Release: InterQual® SmartSheet™ criterion … Effective
August 1, 2016, Tufts Health Plan's Provider. Update … existing step therapy
criteria. ….. Find a CodeTM and Inpatient Admission Notification.

Centene 2012 – True Cost of Health Care

Aug 31, 2015 … years, from 2014 through 2016. …… care unit hospital admissions, other inpatient
hospital admissions, and … accordance with Interqual criteria.

Download the June 2015 Edition – Independence Blue Cross

Jun 1, 2015 … InterQual Level of Care criteria for review of acute inpatient, acute rehabilitation,
skilled … The new criteria allow for appropriate admission of medically complex …
January 1, 2016, a coverage policy will be implemented.


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Medicare replacement (PDF download)

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