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How to Access InterQual® Criteria - Wellmark Blue Cross
InterQual ® criteria, published by Change Healthcare LLC, is used in many of Wellmark’s medical review processes to support the medical necessity of health care services. We are publishing the 2018 annual changes to the criteria for Providers to review prior to implementation. Wellmark Blue Cross and Blue Shield of Iowa, Wellmark Health
Find a Form for Providers | BCBSNE
Blue Cross and Blue Shield of Nebraska is an independent licensee of the Blue Cross and Blue Shield Association. The Blue Cross and Blue Shield Association licenses Blue Cross and Blue Shield of Nebraska to offer certain products and services under the Blue Cross® and Blue Shield® brand names within the state of Nebraska.[PDF]
2017 InterQual guidelines - Independence Blue Cross
Insurance Company, and with Highmark Blue Shield — independent licensees of the Blue Cross and Blue Shield Association. 2017 InterQual® guidelines . Below is a summary of some of the changes included in the 2017 InterQual Level of Care Criteria release. Acute Level of Care updates[PDF]
2018 InterQual guidelines - provcomm
QCC Insurance Company, and with Highmark Blue Shield — independent licensees of the Blue Cross and Blue Shield Association. 2018 InterQual® guidelines . Below is a summary of the changes included in the April 2018 InterQual Criteria release that Independence Blue Cross will begin using on August 20, 2018. Acute Level of Care updates[PDF]
bcbs interqual sheets - Bing - Free PDF Blog. | Just
bcbs interqual sheets FREE PDF DOWNLOAD NOW!!! Source #2: bcbs interqual sheets FREE PDF DOWNLOAD[PDF]
Jiva Update - Blue Cross and Blue Shield of Alabama
Blue Cross and Blue Shield of Alabama is an independent licensee of the Blue Cross and Blue Shield Association. s 2017 ria re B w! Jiva Update Uploading Documents – At this time, you are not required to upload documents such as clinical information sent in for Peer Clinical Review (PCR). being sent should be noted on the fax cover sheet,[PDF]
Interqual guidelines to determine medical necessity - Anthem
Anthem Blue Cross and Blue Shield Medicaid MEDICAID PROVIDER BULLETIN February 2017 utilizing Interqual guidelines for medical necessity criteria. The American Society of Addiction Medicine will be used for substance use. If Interqual does not cover a behavioral health service, Anthem will follow the standardized tools for medical necessity
Preauthorization and Utilization Management | bcbsm
Jun 01, 2019Blue Cross Blue Shield of Michigan uses the following precertification, and preauthorization programs to ensure that our network doctors and hospitals provide the most appropriate and cost-effective care. Clinical necessity and criteria help identify cases that may benefit from the assistance of one of our care management programs.[PDF]
Authorization requirements by product - Blue Cross Blue
Authorization Requirements by Product (rev. 6/19) 3 of 9 Service Commercial HMO/POS PPO and EPO Indemnity Medicare HMO Blue Medicare PPO Blue FEP Genetic Testing Yes9 Yes9 No No No Yes9 Home Health Care Yes10 Yes10 No Yes10 No No Home Infusion Therapy Yes Yes Yes Yes Yes Yes[PDF]
Medical Necessity & Charting Guidelines
Medical Necessity & Charting Guidelines. 2 4 In most cases we are told the rules upIn most cases we are told the rules up front - or will be told if we ask Like most games, the one who knows the rules the bestrules the best InterQual Guidelines for Medical Necessity
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