For Health Services other than Emergency Services, Hospital shall use reasonable commercial efforts to notify Health Plan or Payer and obtain authorization within 24 hours or within the next business day of providing Health Services to Members.  Payer shall make available Electronic Notification Protocol 278N for the purpose of automatic electronic notification of admission from Hospital to Payer at the sole expense of the Plan.  Failure to notify Health Plan of a Member’s admission by the Hospital or failure to obtain authorization shall not affect Hospital’s right to compensation for Health Services rendered to such Members, unless, upon appeal by Hospital and review by Payer, Health Services or State-sponsored or other external review findings deem the services non-covered. Such non-covered services shall automatically become the financial responsibility of the Patient or Guarantor.

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Analyzing & Negotiating Managed Care Agreements
Maria's World-renown Two-Day Master Class



Location: Denver, Colorado

Class size limited to 8 seats (no exceptions) per 2-day session.
Client discount available.