This article is for all providers requesting inpatient surgery authorization
As of September 1, 2021, Authorization Manager will allow you to request authorizations for certain procedures performed in an inpatient setting, including emergency surgery. The InterQual® SmartSheet information you used to submit to us separately is now integrated into the tool. This is in addition to procedures performed in an outpatient setting as noted in our June 11 article.
If the criteria aren’t met, or the code entered is not associated with these services, the authorization will pend for manual review, and you will be notified. Please attach clinical notes.
Launch InterQual from Authorization Manager fact sheets
* Federal Employee Program member requests will pend for review. Please complete the InterQual steps in Authorization Manager to speed up the approval process.
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