New Claims System Update

Provider Manual
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9 Hospital and Elective Admission Management

9.3 Discharge Planning

Discharge planning is designed to assist the provider in the coordination of a member’s discharge when acute care (hospitalization) is no longer necessary. The IntegraNet concurrent review nurse or case manager (working with the IntegraNet Medical Director) will assist providers and hospitals with the discharge planning process in accordance with requirements of the Medicare Advantage program. At the time of admission and during the hospitalization, IntegraNet will discuss discharge planning with the provider, member and/or member advocate.

When the provider identifies medically necessary and appropriate services for the member, IntegraNet will assist the provider and the discharge planner in providing a timely and effective transfer to the next appropriate level of care.