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As the University of Illinois Urbana-Champaign Office of Undergraduate Admissions, it's our mission to uphold the policies and procedures outlined below.
Policies & procedures
Mandatory concurrent review good date ideas Mobile AL of admission and continued stay review will be implemented effective with admissions on and after March 1,for those diagnoses on Attachments A, B, and C.
However, based on input from various stakeholders, HFS is allowing a day transition period for hospitals to comply with mandatory concurrent review. All Illinois hospitals and out-of-state hospitals in counties contiguous to Illinois must participate in Concurrent Review for all diagnoses subject to review. Effective with admissions on and after June 1,hospitals that do not follow the mandatory concurrent review process will receive rejections with the new error code A88 — No Certification on File.
Claims that did not receive certification of the admission will not be payable. The department will allow limited exceptions to mandatory concurrent review in que Haven flirt following circumstances:.
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Medicare Part A coverage exhausted while the patient was in the hospital, but the hospital was not aware that Part A exhausted. Claims that relate to an exception must be submitted with a cover memo that identifies the exception.
After HFS reviews the exception, the claim will suspend for retrospective prepayment exciting date ideas in Atlanta Georgia GA. Exceptions relating to Medicare Part A exhaust require Medicare verification of exhausted benefits. Effective June 1,HSI will conduct quarterly analysis for HFS regarding the of claims impacted by exceptions to mandatory concurrent review. In an informational notice dated November 28,the department notified hospitals that effective March 1,HealthSystems of Illinois HSI will only conduct off-site reviews for all diagnosis codes and DRGs subject to review.
Hospitals will be required to submit the medical record to HSI for review. Additionally, the hospital will be required to submit the medical record for inpatient stays selected for postpayment review.
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Hospitals are informed that any 4th or 5th digit code extension dateinasia Rapids dating a three-digit root code, approved as the admitting diagnosis code online dating Cedar Rapids stories the time of the certification of admission, will be acceptable on the claim submitted to the department.
As an example, if the code supplied by the hospital to HSI at the time of the certification of admission was Diagnosis code This code was subject to review prior to the last update and continues to be subject to review. Attachment C has been corrected.
Any questions regarding this notice may be directed to the Bureau of Healthcare Quality Improvement at HFS Home Illinois. Content.
Provider notice issued 02/27/07
This notice provides an update on forthcoming utilization review changes. Need Assistance? Report a Web Problem.