[
In order to efficiently conduct admission reviews of inpatient emergency
admissions, clinical information regarding
the member's medical condition and treatment is required. Clinical information
should be provided within a short time
frame after notification of emergency admissions. Ideally, this information
should be sent to Independence within two
business days. Failure to provide the required information within 30 days
of notification of admission will result in
case closure with a denial due to lack of information.
Should the hospital receive a denial due to lack of information, the request
for an admission review can be
resubmitted when the clinical information is available. To submit the new
request, call 1-800-ASK-BLUE and follow
the prompts for authorizations. Please note that the submission of complete
medical records is not required and could
delay the admission review process.
For questions regarding this information, please contact Alfreda Earp,
administrative assistant, at 215-241-3065,
and she will direct your inquiry to the appropriate area.
]