Utah Admin. Code R414-515-5 - Service Coverage
(1) A member must
receive prior authorization for preadmission, continued stay, and retroactive
reviews.
(2) An LTAC provider must
submit to the Department a request for coverage that includes current and
comprehensive documentation, or the Department will return the request as
incomplete.
(3) The Department
shall consider LTAC coverage upon the date it receives the request with
current, comprehensive documentation.
(4) The Department shall review the
documentation to determine preadmission, continued stay, or retroactive stay
within three business days of the request.
(5) An LTAC provider may not transfer prior
authorization to another L T A C provider.
(6) If a member transfers from an LTAC
hospital to an acute care hospital for any reason, and is away from the LTAC
hospital for more than 24 hours, the LTAC provider shall submit a new
preadmission review before transferring the member back to the LTAC
hospital.
(7) The Department
authorizes each approved prior authorization for up to 28 days.
Notes
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