TitleWeb
Upcoming process change for the review of emergency admissions
							
																	
						
							Professional; Facility; Ancillary
						
					 
					
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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.