![]() ![]() Behavioral health organizations can be freestanding or hospital-based.Ī disagreement regarding a claim or utilization review decision. Examples of organizational providers include, but are not limited to: hospitals, nursing homes, skilled nursing facilities (SNF), home care agencies, free standing surgical centers, birthing centers, urgent care centers, pain management centers, ambulance services, pharmacies, hospices, infusion centers, blood banks, diagnostic testing centers, diabetic treatment centers, residential treatment facilities, MRI centers, independent durable medical equipment vendors, orthotics facilities, oncology treatment centers, optical facilities and sleep diagnostic centers.īehavioral health organizations include, but are not limited to: mental health and chemical dependency hospitals, residential treatment facilities, partial hospital programs, intensive outpatient programs and clinics. Institutional providers and suppliers of health care services, including behavioral health care organizations. ![]() Examples include doctors, podiatrists and independent nurse practitioners. The following definitions apply in an insurance dispute: Practitioner:Īn individual who is licensed or otherwise authorized by the state to provide health care services. See our answers regarding the insurance dispute process Definitions (Please note that state requirements take precedence when they differ from our policy.) It applies to all our medical benefits plans. The information below explains when and how to submit a dispute. Health care professionals and organizational health care providers can dispute adverse decisions. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |