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Pediatric Nursing Impact: Medical Necessity Documentation
[2451]
$30.00


[2451] Pediatric Nursing Impact: Medical Necessity Documentation

Summary: UHC's program directors share important details on proper documentation for Medical Necessity.

HCSSA Topic(s) Addressed:

  • §97.259[d][4]agency responsibilities
  • §97.260[a][2]development and interpretation of agency policies
  • §97.260[a][8]skills for working with clients, families, and other professional service providers

Faculty: Stowers, David; Garcia, Julie [UHC]

Program Description: In this program the presenters provide you with significant guidelines - direct from the managed health care organizations' (MCO's) "playbook" on pediatric home care nursing documentation - and how that documentation plays a vital part of ensuring managed care organizations’ authorization and approval for appropriate treatment.

Program Objectives: Upon completion of this program, the viewer will be able to:

  • Explain medical necessity standards for Medicaid children, birth through age twenty
  • Compare the differences in medical necessity standards for Medical adults
  • Identify required critical elements for Notices of Action for Medicaid children, birth through age twenty
  • Evaluate the notification process for incomplete prior authorization request for Medicaid children, birth through age twenty
  • Discuss avoiding denials through correct documentation of medical necessity- building on best practice nursing documentation
  • Manage coordination of care with other service providers
  • Discuss what is expected of our Managed Care Organizations (MCOs)

About the Presenters:
David Stowers, BSN, MSN, RN
is the Health Services Director of the STAR Medicaid program for United Health Care.

Julie Garcia, RN is the Health Services Director for United Health Care's Community Plan.

Education-Training Credits:

  • 1.00 Hr(s) HCSSA Administrator/Alternate

[2451] Pediatric Nursing Impact: Medical Necessity Documentation

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This product was added to our catalog on Monday 01 July, 2013.
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