TitleWeb
Upcoming process change for the review of emergency admissions
Professional; Facility; Ancillary
Page Content
Effective April 1, 2013, IBC?s Care Management and Coordination (CMC)
department is changing the process for the review of emergency admissions
following notification through the NaviNet? web portal.
CMC will no longer remind hospitals to provide clinical information to complete
the medical necessity review for authorization and payment. Hospitals will need
to provide the clinical information to CMC within two business days of notice
to complete authorization. Failure to provide clinical information to CMC in a
timely fashion may delay reimbursement.
Upon completing the notice of the emergency admission, hospitals will receive a
modified NaviNet message as a reminder to submit clinical information to
complete authorizations. Hospitals may also refer to NaviNet to confirm the
status of any authorization. To do so, select ER Admission Notification from
the Authorizations option in the Plan Transactions menu.
If you have any questions about this change in procedure, please contact
Marianne Brown, Manager of Utilization Management at 215-241-4655.