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Reminder: Our policies on inpatient hospital readmissions

May 4, 2017

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As a reminder, Independence expanded its policies on inpatient hospital readmissions to include a 6 ? 30 day provision. The following policies went into effect January 15, 2017:

  • Commercial: #00.01.47c: Inpatient Hospital Readmission
  • Medicare Advantage: MA00.023a: Inpatient Hospital Readmission

The pre-existing 0 – 5 day provision remained unchanged. Recoveries for readmissions between 6 – 30 days found to be related, preventable, or avoidable will be pursued on a post-pay basis.

Note: As per your Independence Agreement, members may not be billed for the denied services.

More information

To access these policies, visit our Medical Policy Portal. Select Accept and Go to Medical Policy Online, then select either the Commercial or Medicare Advantage tab from the top of the page and type the policy name or number in the Search field.

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