"milliman care guidelines" inpatient and surgical care

Hello Again,
Good anyone direct me to a copy of "milliman care guidelines"
inpatient and surgical care, 10th edition. It would be really helpful
in my insurance struggle.
Thank You

On Mar 3, 9:05 am, Steve:

> Hello Again,
> Good anyone direct me to a copy of "milliman care guidelines"
> inpatient and surgical care, 10th edition. It would be really helpful
> in my insurance struggle.
> Thank You


http://www.careguidelines.com/

Important Information About the Milliman Care Guidelines®

The Care Guidelines can be used by qualified, healthcare professionals
as a tool in making medical necessity decisions, but they should not
be used as the sole basis for denying coverage of payment. The Care
Guidelines must be applied to the individual patient on a case-by-case
basis and always in the context of a qualified, healthcare
professional's clinical judgment.



--------------------------------------------------------------------------------

On Mar 3, 3:40 pm, "Fire Chief" <CALIFORNIA_CH...@PEOPLEPC.COM> wrote:
> On Mar 3, 9:05 am, Steve:
>
> > Hello Again,
> > Good anyone direct me to a copy of "milliman care guidelines"
> > inpatient and surgical care, 10th edition. It would be really helpful
> > in my insurance struggle.
> > Thank You
>
> http://www.careguidelines.com/
>
> Important Information About the Milliman Care Guidelines®
>
> The Care Guidelines can be used by qualified, healthcare professionals
> as a tool in making medical necessity decisions, but they should not
> be used as the sole basis for denying coverage of payment. The Care
> Guidelines must be applied to the individual patient on a case-by-case
> basis and always in the context of a qualified, healthcare
> professional's clinical judgment.
>
> ---------------------------------------------------------------------------*-----

Thank You Fire Chief,
Without seeing the guidelines I have a hard time determining why I
was turned down. My denial letter said I have a right to all
documentation used in that decesion. Maybe they have to send it to me?

Steve wrote:

> Thank You Fire Chief,
> Without seeing the guidelines I have a hard time determining why I
> was turned down. My denial letter said I have a right to all
> documentation used in that decesion. Maybe they have to send it to me


If that's what the letter said, I would demand it.


.... For a rash of good luck, cross poison ivy with a 4-leaf clover.