New Claims System Update

Provider Manual
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9 Hospital and Elective Admission Management

9.5 Post-Stabilization Care Services

Post-stabilization care services are covered services related to an emergency condition provided after a patient is stabilized to maintain the stabilized condition or improve or resolve the patient’s condition. Precertification is not required for emergency services in or out of the network. All emergency services are reimbursed at least at the Medicaid Network Rate. IntegraNet will adjudicate emergency and post-stabilization care services that are medically necessary until the emergency condition is stabilized and maintained.