medi-cal managed care requirements for discharge summaries

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medi-cal managed care requirements for discharge summaries

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Instructions – California Department of Aging – State of California

www.aging.ca.gov

The CBAS Discharge Summary Report (CDA 4008) provides summary … Medi-
Cal managed care plan or fee-for-service. … Code of Regulations, Title 22.

Medical Record Review Guidelines – California Department of …

www.dhcs.ca.gov

Medical Record Review Guidelines. California Department of Health Services.
Medi-Cal Managed Care Division. Purpose: Medical Record Survey Guidelines …

Complying With Medical Record Documentation Requirements

www.cms.gov

nationally-consistent education on topics of interest to health care … Visit the
Centers for Medicare & Medicaid Services (CMS) CERT webpage to review …
The CERT Program is managed by two contractors, the CERT Statistical …
management but it failed (for example, medication administration records,
therapy discharge.

Discharge Planning – CMS.gov

www.cms.gov

Due to low usage, the Medicare Learning Network® discontinued the Discharge.
Planning Booklet (908184). You can find information on discharge planning.

CMS Manual System – CMS.gov

www.cms.gov

I. SUMMARY OF CHANGES: The purpose of these revisions is to include …
Appendix B/484.18(c)/Standard: Conformance with Physician Orders/Tags … who
have been discharged from skilled care, and to other individuals in the
community …. Medicare's health and safety requirements when an HHA provides
services …

Your Medical Documentation Matters – CMS.gov

www.cms.gov

Dec 20, 2015 … and State Medicaid documentation regulations and rules. To illustrate these
points, the case study follows a patient's course of treatment through several
medical ….. A discharge summary is a Medicaid requirement and includes the
patient ….. providers, even those providing services through managed care.

Center for Clinical Standards and Quality/Survey & Certification …

www.cms.gov

May 17, 2013 … Guidelines for 42 CFR 482.43, Discharge Planning … I. SUMMARY OF
CHANGES: Clarification is provided for the provisions of 42 CFR …. Other
healthcare facilities and professionals who provide care to discharged patients,
…… (ii) – For patients enrolled in managed care organizations, the hospital must …

An All-Payer View of Hospital Discharge to Postacute Care … – HCUP

www.hcup-us.ahrq.gov

May 1, 2016 … require continued postacute care (PAC) to support recovery, … This Healthcare
Cost and Utilization Project (HCUP) Statistical Brief presents data … Notes:
Discharges to IRFs and LTCHs were not identified in one State. ….. Medicare:
includes patients covered by fee-for-service and managed care Medicare.

Managed Care Supplement – SCDHHS.gov

www.scdhhs.gov

Apr 1, 2016 … Primary Care Provider Requirements – Medically Complex Children's …. This
Managed Care supplement is intended to provide an overview of …. referrals for
follow-up care after discharge from a hospital also require a referral …

Care Manager Standards – New York State Department of Health

www.health.ny.gov

primary care physician/nurse practitioner, specialist(s), behavioral health care ….
to follow-up care post discharge that includes at a minimum receipt of a summary
…. The Health Home must inform the Managed Care Plan of the member's AOT.

Home Health Services – Utah Medicaid – Utah.gov

medicaid.utah.gov

professional. 1-2 Fee-For-Service or Managed Care …. necessity. After the initial
visit, all home health care services require prior authorization. … Clinical
documentation supporting the client needs for care, e.g., discharge summary,
history and.

Table of Contents – Department of Drug and Alcohol Programs

www.ddap.pa.gov

Jun 27, 2013 … C.2CONTINUED STAY CRITERIA OVERVIEW ……………………………………………………..
……………………………………… 19. D. LEVELS OF CARE AND PLACEMENT CRITERIA
. … D.2.4 Level 1A (Outpatient) Discharge Criteria Across 6 Dimensions . ….. D.
9.3 Level 4A (Medically Managed Inpatient Detox) Continued …

Improving Health Care: A Dose of Competition – Federal Trade …

www.ftc.gov

Centers for Medicare & Medicaid Services; and the Offices of the Assistant
Secretary for Planning &. Evaluation and the General … Chapter 1 provides an
overview …. regulations to influence the price and quality of the services …. as
managed care and preferred provider … discharge determines the amount that
the hospital …

MSA 16-13 – State of Michigan

www.michigan.gov

May 19, 2016 … Note: Continuation of the MI Care Team policy/benefit after eight (8) quarters of
the … Pursuant to the requirements of Section 2703 of the Patient … fee-for-
service and managed care beneficiaries enrolled in Medicaid, the Healthy ….
care records, continuity of care documents, and discharge summaries; …

Hospital Project – ahcccs

www.azahcccs.gov

mental illness designation, who are being discharged from an inpatient stay. 1. …
Current, the health information exchange, AHCCCS managed care organizations
… health authorities (RBHAs), and hospital-based electronic medical records. …
Hospital Reporting Requirement to State … providing the discharge summary.

General Information Claim Submission Requirements – ahcccs

www.azahcccs.gov

May 24, 2016 … Claims must meet AHCCCS requirements for claims submission. In the absence
of … investigation for fraud or abuse or claims under review for medical necessity.
… AHCCCS Managed Care Contractors are not responsible for determining prior
quarter coverage or for ….. office records, discharge summary,.

MACfacts: Medicaid UPL Supplemental Payments – macpac

www.macpac.gov

Although the UPL regulations were intended to limit Medicaid payments to a
group of institutions to the amount … Notes: Excludes payments made under
managed care arrangements. CMS only … out on a fixed per Medicaid discharge
basis,.

Integrated Care for People with Medicare and Medicaid: A … – NCQA

www.sandiegocounty.gov

which seniors receive medical treatment and human services that are integrated
in the … Executive Summary … of different coverage and program administration
requirements, states have found it ….. people to use a managed care plan for
Medicare (indeed, people with ….. were reconciled on or within 30 days of
discharge.

Indiana Medicaid Managed Care Quality Strategy Plan 2015 – IN.gov

www.in.gov

FSSA is charged with oversight of the Managed Care Entities and the Care … The
contracted health plans must meet FSSA contract requirements which include …
HISTORY AND OVERVIEW OF INDIANA's RISK BASED MEDICAID MANAGED
CARE PROGRAMS. 4 ….. within 7 days of discharge from hospitalization for.

Hospital Services Handbook for Inpatient Services – State of Wisconsin

www.forwardhealth.wi.gov

Medicaid managed care program name and telephone number. – Privately
purchased …. Same Day Admission/Discharge — Obstetrical and Newborn Stays
………………. 14 …. Documentation Requirements for Certification of Need
Assessments …………………. 21 …… reports in a summary format on a weekly basis
to Wisconsin …





AARP health insurance plans (PDF download)

Medicare replacement (PDF download)

AARP MedicareRx Plans United Healthcare (PDF download)

medicare benefits (PDF download)

medicare coverage (PDF download)

medicare part d (PDF download)

medicare part b (PDF download)


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