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POSITIVE HOSPITALIZED INPATIENTS Reports are line lists of patient records. Reports are ideally generated from hospital EHR/EMR systems instead of manually. Each row (line) corresponds to one patient admission (a single admit date).
What is notification of admission?
Timely notification of admissions assists with timely payment of claims, reduces retroactive admission reviews and enables CHWP to concurrently monitor member progress. SERVICES REQUIRING NOTIFICATION.
What is an inpatient report?
Inpatient care is care provided in a hospital or other type of inpatient facility, where you are admitted, and spend at least one nightsometimes moredepending on your condition. As an inpatient: You are under the care of doctors, nurses, and other types of health care professionals within a hospital.
What is inpatient notification?
An inpatient hospital notification is required for all members to ensure care coordination and that all inpatient hospital services paid under PrimeWest Health are medically necessary and consistent with the members diagnosis or condition and cannot be provided on an outpatient basis.
What does inpatient mean in medical terms?
An inpatient is a hospital patient who, in most cases, stays in the hospital overnight and meets a set of clinical criteria. Outpatients are people who receive care or hospital services and return home the same day.
required hours
Inpatient admission concurrent review fax formAdmission concurrent review fax form pdfPremera Individual plan prior authorization formPremera inpatient notification formBlue Cross Blue Shield Association prior authorization FormPremera out-of-network exception formPremera fax cover sheetBcbs forms for providers
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For ongoing stay authorization beyond the 3 initial days, please submit list of documents listed on page 2 for concurrent review within 72 hours of admission.
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