"milliman care guidelines" inpatient and surgical care

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Damifino - 03 Mar 2007 17:05 GMT

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

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Fire Chief - 03 Mar 2007 20:40 GMT

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.

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

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Damifino - 04 Mar 2007 15:16 GMT

> On Mar 3, 9:05 am, Steve:
>
[quoted text clipped - 16 lines]
>
> --------------------------------------------------------------------------------

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?

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Fire Chief - 05 Mar 2007 05:30 GMT

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.

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