Pre-admission Certification definition

Pre-admission Certification means approval by Your pre-certification company of the Medical Necessity for a proposed Confinement in a Qualified Treatment Facility, and the appropriate length of stay.
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Pre-admission Certification means approval by CMC of the Medical Necessity for a proposed Confinement in a Qualified Treatment Facility, and the appropriate length of stay.
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Pre-admission Certification means a procedure which consists of review and certification by Us prior to an Inpatient Admission, that a proposed Admission is both Medically Necessary and appropriate as to setting and length of stay. It is based upon information provided by the Member’s Physician, Hospital, Designated Unit, or a representative thereof, applying medically accepted review criteria.
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Examples of Pre-admission Certification in a sentence

  • If either you or your dependent is admitted without obtaining Preadmission Certification, an added deductible of $500.00 will be applied to your hospital coverage.

  • The program consists of any applicable Pre-admission Certification, Admission Certification of Emergency Admissions, Outpatient Procedure or Covered Service Precertification, Continued Stay Review, Discharge Planning, and Individual Case Management.

  • These services will include: Mandatory Pre-admission Certification Program with pre-service authorization and a penalty as directed by the Plan.

  • The plan will include Preadmission Certification, Continued Stay Review and Mandatory Second Opinion.

  • Effective July l, l997, Hospital Preadmission Certification (HPC) will be added to the Board's traditional medical insurance program.

  • The Board of Education shall provide health, dental and vision insurance that is equal to or better than the current coverage The plan will include Preadmission Certification Continued Stay Review and Mandatory Second Surgical Opinion.

  • This Program includes Inpatient Notification and Preadmission Certification.