Continued stay review definition

Continued stay review means a review of a client's functioning to determine the need for further services to achieve or maintain service goals and objectives.
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Continued stay review means a periodic, supplemental, or interim review of a resident performed by a Department health care professional either by telephone or on-site review.
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Continued stay review means the process required for Title XIX funding by which stays in inpatient hospitals (42 CFR
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Examples of Continued stay review in a sentence

  • In the case of a Participant's Hospital admission and/or course of treatment where there is an admission for Emergency Care (including Maternity and Maternity-related conditions), a Continued Stay Review shall be initiated by or on behalf of the Participant within 48 hours of such admission.

  • The Continued Stay Review shall establish the appropriate length of stay for the admission.

  • The purpose of the Continued Stay Review shall be to determine the Medical Necessity of such admission, as well as the Medical Necessity of any continued hospitalization.

  • Pre-Admission Certification and Continued Stay Review (PAC/CSR) is a process performed through a utilization review program that is used to certify the medical necessity and length of any inpatient hospital confinement.

  • The term Medical Plan" means the benefits specifically described in Articles 3 and 7 and Section 2.07, subject to the applicable Copayments, Deductibles, Coinsurance, Annual Out-of-Pocket Limits, Pre-admission Review, Continued Stay Review and Case Management rules and other limits, exclusions, terms and conditions set out in this Plan.

  • If a request for Pre-Admission Review or Continued Stay Review is not made within the period prescribed above, or the request is denied, and the Participant nevertheless obtains treatment on an Inpatient basis, the Participant shall be subject to the Review Deductible in each such case in the amount of $500 per Participant per occurrence.

  • A Continued Stay Review, which shall be initiated by the Participant, and certification shall be required for any additional days.

  • The term "Review Deductible" means the amount the Participant is responsible to pay for otherwise covered charges incurred for each failure to obtain or comply with a Pre-Admission Review and/or a Continued Stay Review.

  • No Pre-Admission Review or Continued Stay Review shall be required for coverage of the mother's or newborn's Hospital stay of 48 hours or less following vaginal delivery or of 96 hours or less following a cesarean section delivery.

  • Continued Stay Review shall be required for approval of days beyond those certified through Pre-Admission Review and Continued Stay Review.


More Definitions of Continued stay review

Continued stay review means a review used to determine that a members stay in a service is medically necessary and that care is being rendered at the appropriate level.
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Continued stay review means a reassessment by the case manager to determine the Client’s
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Continued stay review means a periodic, supplemental, or interim review of clinical information for an LTAC member.
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Continued stay review means a review used to determine that a member’s continued stay in a service is medically necessary and that care is being rendered at the appropriate level of care or service intensity.
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Continued stay review means the review of a Hospital admission to determine if it is Medically Necessary to continue to be a bed patient.
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Continued stay review means the process required for Title XIX funding by which stays in inpatient hospitals (42 CFR 456.128 to 132), inpatient psychiatric facilities inclusive of residential treatment centers and subacute facilities (42 CFR 441.155(c), and mental hospitals (42 CFR 456.233 to 238) are reviewed to determine the medical necessity and appropriateness of continuation of the member's stay at an inpatient level of care.
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Related to Continued stay review

  • Independent testing laboratory means an independent organization, accepted by the Contracting Officer, engaged to perform specific inspections or tests of the work, either at the site or elsewhere, and report the results of these inspections or tests.

  • Medical examination means the preliminary assessment of a person by an authorized health worker or by a person under the direct supervision of the competent authority, to determine the person’s health status and potential public health risk to others, and may include the scrutiny of health documents, and a physical examination when justified by the circumstances of the individual case;

  • Medical Review Officer (MRO) means a licensed physician responsible for receiving and reviewing laboratory results generated by the school district’s drug testing program and for evaluating medical explanations for certain drug tests.

  • Participating Certified Nurse-Midwife means a Certified Nurse-Midwife who has a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield Plan to provide services to you at the time services are rendered.

  • Participating Clinical Professional Counselor means a Clinical Professional Counselor who has a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield Plan to provide services to you at the time services are rendered.

  • Participating Certified Clinical Nurse Specialist means a Certified Clinical Nurse Specialist who has a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield Plan to provide services to you at the time services are rendered.

  • Emergency medical condition means a medical condition manifesting itself by acute symptoms of sufficient severity (including severe pain) so that a prudent layperson, who possesses an average knowledge of health and medicine, could reasonably expect the absence of immediate medical attention to result in a condition described in clause (i), (ii), or (iii) of section 1867(e)(1)(A) of the Social Security Act (42 U.S.C. 1395dd(e)(1)(A)).

  • Non-Participating Clinical Professional Counselor means a Clinical Professional Counselor who does not have a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield Plan to provide services to you at the time services are rendered.