CARE IMPROVEMENT - Attention: Participating Providers Effective April 20, 2015, Care Improvement Plus (CIP) will begin to perform a concurrent medical.

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Presentation transcript:

CARE IMPROVEMENT - Attention: Participating Providers Effective April 20, 2015, Care Improvement Plus (CIP) will begin to perform a concurrent medical necessity review for acute hospital stays for participating providers and integrate the Center for Medicare and Medicaid Services (CMS) Two Midnight Rule as part of the clinical criteria for the concurrent medical necessity review. This means that Participating providers should submit a notification and the supporting clinical documentation that will support the clinical review process. - Educational webinars will start in May - UM Provider Fact Sheet

UNITED HEALTHCARE UnitedHealthcare has fully integrated the Two Midnight Rule into our Medicare Advantage inpatient management medical necessity review process. Integration of the Two Midnight Rule allows UnitedHealthcare to work with our care providers to meet CMS medical necessity requirements related to inpatient admissions. Integration for the Two Midnight Rule for Critical Access Hospitals will occur on July 1, April Summary Updates

ISSUES - There is going to be a representative from United Healthcare at the meeting next week. Please submit any issues you are having (claim specific) to Dale this week.

THANK YOU -

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