Examples of Inpatient facility in a sentence
This call must be made prior to the scheduling of your admission.In the event of an emergency admission after transferring from an Inpatient facility where you were receiving acute care, you or someone who calls on your behalf, must, in order to receive maximum benefits under this Certificate, notify Blue Cross and Blue Shield no later than two business days or as soon as reasonably possible after the admission has occurred.
If the call is made any later than the specified time period, you will not receive maximum benefits.Prior to receiving services for the following Physician recommended service(s) after transferring from an Inpatient facility where you were receiving acute care, you must, in order to receive maximum benefits under this Certificate, call Blue Cross and Blue Shield.
When you call Blue Cross and Blue Shield, a case manager may be assigned to you for the duration of your care.TRANSFER INPATIENT SERVICE PREAUTHORIZATION REVIEWPrior to a Physician recommended admission to a Skilled Nursing Facility, a rehabilitation facility, or a long term acute care facility after transferring from an Inpatient facility where you were receiving acute care, you must, in order to receive maximum benefits under this Certificate, call Blue Cross and Blue Shield.
In addition, a nonparticipating provider or non-PPO provider can bill the Member for the difference between payment by Blue Cross and Blue Shield of Montana and provider charges plus Deductible, Coinsurance and/or Copayment even if the service is an Emergency Service or the if the service has been Preauthorized.Preauthorization Process for Inpatient ServicesFor an Inpatient facility stay, the Member must request Preauthorization from The Plan before the Member’s scheduled admission.
Concurrent Review – A review of Medical Necessity, appropriateness of care, or level of care conducted during a patient's Inpatient facility stay or course of treatment.