Hospital Inpatient Services. All hospitalizations require prior authorization (except for maternity and Emergency admissions as specified). The Member must contact (or have the provider contact CareFirst) at least five (5) business days prior to an elective or scheduled admission to the hospital. If the admission cannot be scheduled in advance because it is not feasible to delay the admission for five (5) business days due to the Member’s medical condition, CareFirst must receive notification of the admission as soon as possible but in any event within forty-eight (48) hours following the beginning of the admission or by the end of the first business day following the beginning of the admission, whichever is later. Emergency Admissions CareFirst may not render an adverse decision solely because CareFirst was not notified of the emergency admission within the prescribed period of time after that admission if the Member’s condition prevented the hospital from determining the Member’s insurance status or CareFirst’s emergency admission requirements.
Hospital Inpatient Services. 1. The MCO will share responsibility for inpatient general hospital services with the BHP.
Hospital Inpatient Services. All hospitalizations (except for maternity admissions as specified) require prior authorization. The Member must contact CareFirst (or have the provider contact CareFirst) at least five (5) business days prior to an elective or scheduled admission to the hospital. If the admission cannot be scheduled in advance because it is not feasible to delay the admission for five (5) business days due to the Member's medical condition, CareFirst must receive notification of the admission as soon as possible but in any event within forty-eight (48) hours following the beginning of the admission or by the end of the first business day following the beginning of the admission, whichever is later. Note the following:
Hospital Inpatient Services. (1) ACUTE CARE When a Participating Provider obtains preauthorization and admits Members to a hospital for acute care, Contractor will cover: _ semi-private room and board; _ isolation, coronary or other special acute care units, when Medically Necessary; and _ Hospital Services and supplies necessary for treatment and furnished by Participating Hospital, such as operating and recovery rooms, blood and blood components, traction equipment and special diets. Coverage for take home prescription drugs following a period of hospitalization and dispensed by the hospital will be limited to a three-day supply. Referrals to a Non-Participating Hospital must be preauthorized by PacifiCare unless a medical emergency necessitates such admission. A preauthorized hospitalization in a Non-Participating Facility will be covered. In a medical emergency, benefits paid to a Non-Participating Facility will continue until the OMAP Member can be safely transported to one of PacifiCare's Participating Facilities for continued hospitalization. OMAP Members refusing transport to a Participating Facility when it is safe for them to transfer will forfeit continued benefits for that hospitalization and all concurrent Non-Participating Provider care.
Hospital Inpatient Services. All elective inpatient hospital admissions (except for maternity and emergency admissions) require prior authorization. The Network Provider must contact Evergreen Health at least five (5) business days prior to an elective or scheduled admission to the hospital. If the admission cannot be scheduled in advance because it is not feasible to delay the admission for five (5) business days due to the Member’s medical condition, Evergreen Health must receive notification of the admission as soon as possible but in any event within forty-eight
