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Inpatient Notification Required to the Plan in January

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Effective Jan. 11, 2021, all acute inpatient hospitalizations require notification to the plan (Samaritan Health Plans/InterCommunity Health Network CCO) within the following parameters to ensure appropriate coordination of care for members:

  • Notifications must be submitted via fax within 24 hours of admission, or next business day for weekend or holiday admissions.
  • Observation stay notifications should be sent as soon as stay exceeds 48 hours or within 24 hours of the inpatient order.
  • All inpatient stay notifications are subject to medical necessity review.
  • Clinical information must be received within 48 hours following the request.

Notifications should include the following:

  • Member demographic information.
  • Member date of birth.
  • Member ID.
  • ICD-10 codes.

Incomplete notifications or late notifications may cause a delay in coordination of care and result in an administrative denial of care provided prior to the date in which  the notification is received.

If you have additional questions or need assistance, contact SHP Customer Service at 541-768-5207 or 888-435-2396, Monday through Friday, 8 a.m. to 5 p.m.