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Group 4 Graduation

Colleen D'Amico, MS, RN
Horizontales
Format to send information to MD in your referral
Second best friend to prevent errors within MCG
This allows you to add additional days beyond the original service line
Contact to the facility/member with your decision
Document to assist with determining which letter/fax to send
Where to send COVID-19 cases that have been denied, have no information or need an RFI
Commercial, Medicare and Medicaid
Where to send your closed cases - think purgatory
NRA associated with approved cases
Verticales
When a member is hospitalized within 30 days of a prior hospitalization
What NOT to select when attempting to close an MCG window
Function to send a referral to an MD
Template to be used prior to denial letter
Dates covering a period of the hospitalization
Section to document approval or denial