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

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 –

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®

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

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 –

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 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

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.

AARP MedicareRx Plans United Healthcare (PDF download)

AARP health insurance plans (PDF download)

Medicare replacement (PDF download)

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