Preadmission Certification Clause Samples
Preadmission Certification. Continued Stay Review (required for all Inpatient Admissions) Mandatory 20% penalty reduction up to $500 applied to hospital inpatient charges for failure to contact Contemporary Health Care Management (CHCM) to precertify admission (employee responsible for contacting CHCM. 20% reduction up to $500 for any admission reviewed by CHCM and not certified. 20% reduction up to $500 (room and board) for any additional days not certified by CHCM.
Preadmission Certification. Benefits for all Covered Services provided for a nonemergency Hospital Admission must be precertified. If preadmission certification is not possible, then admission certification must be obtained within 24 hours of the admission or the next business day, whichever occurs first.