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Click ‘Get Form’ to open the INPATIENT SURGERY PROCEDURE REQUEST FORM in the editor.
Begin by entering the Member’s Date of Birth (DOB) in the designated field. This is crucial for identifying the patient.
Fill in the Member’s Name and ID number accurately to ensure proper processing of the request.
Specify the Plan, which in this case is HUSKY A, followed by entering the Date of Admission and Anticipated Number of Days for hospitalization.
Provide details about the Hospital, including its Billing Hospital CMAP ID, and clearly state the Name of Surgery/Procedure(s) along with their respective Procedure Code(s) and Diagnosis Code(s).
Enter information for the Surgeon/Admitting MD, including their NPI Number, as well as a Contact Name and Phone number for follow-up.
Ensure all fields are filled out completely as ALL fields MUST be completed to process your request. Remember to include clinical notes before submitting.
Once completed, fax your request along with clinical information to 203.265.3994. Please allow 5 business days from receipt of all clinical information for processing.

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How to prepare for inpatient surgery?

Here are some things you can do to ensure youre ready: Attend all appointments and educational seminars as directed by your surgeon. Take your medications as directed. Reduce or quit smoking. Eat healthy foods, such as fruits, vegetables, lean meats and whole grains, and drink enough fluids to stay well-hydrated.

What should you not do 7 days before surgery?

7 DAYS before surgery: Plavix, Pradaxa, Eliquis (blood thinners) Aspirin. Any anti-inflammatory medication (except Celebrex) Ibuprofen (Advil, Motrin, Midol, Nuprin, Pamprin) Naprosyn (Aleve, Naproxen, Anaprox) Voltaren. Any herbal supplements. Vitamins (multivitamin, etc)

How to build up the immune system before surgery?

Focusing on a healthy diet in the weeks leading up to surgery can help you feel better faster post-surgery, bolster your immune system and speed healing. The weeks before surgery are a really good time to increase your protein intake, says Picano.

What is considered an inpatient procedure?

Typically, inpatient care requires an overnight stay in a hospital or other care setting. Inpatient care tends to include more serious surgeries, procedures and care that require at least 1 overnight stay. Sometimes these visits are planned (like having a baby) and other times theyre not (like breaking a major bone).