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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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