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[PDF File]Sources of Utilization Management Criteria for GEHA’s ...
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Milliman, Medical Policy, UnitedHealthcare policy.* *UnitedHealthcare Guideline statement updated February 19, 2020: The UnitedHealthcare utilization management program is based on evidencebased - medicine guidelines that are applicable to certain conditions having …

[PDF File]Medical Necessity & Charting Guidelines
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Industry Guidelines for determination of Medical Necessity used by payor sources: Milliman® InterQual® Payors will approve day/s for patient stay based on these guidelines. Hospital and physicians have signed contract to use these guidelines

CUSTOMIZATIONS TO MCG™ CARE GUIDELINES FORMERLY …
2. Customizations to MCG Care Guidelines (formerly Milliman Care Guidelines) clinical indications with changes to the original MCG (formerly Milliman) criteria which includes adding or revising appropriateness criteria. 3. Customizations to MCG Care Guidelines (formerly Milliman Care Guidelines) goal length of stay

[PDF File]KAISER PERMANENTE Revised Milliman Guidelines NICU Levels*
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Milliman Care Guidelines The portions of the guideline(s) which have been revised are identified through the use of italics text, and Milliman has neither reviewed nor approved the modified material.

[PDF File]2019 2020 Magellan Care Guidelines
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Magellan also uses The ASAM Criteria® and other state-developed guidelines (e.g. Texas Administrative Code (TAC) §3.8001-3.8030 Standards for Reasonable Cost Control and Utilization Review for Chemical Dependency Treatment Centers guidelines for cases in Texas) for management of substance use services when required by state regulations or an

[PDF File]News Flash – The revised fact sheet titled “Sole Community ...
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contractors in specific jurisdictions may use to assist in the review of medical documentation to determine if a hospital admission is medically necessary. These …

How to use milliman guidelines