Health / Health Insurance / Pre-Admission Certification: Also called pre-certification review, or pre-admission review. Approval by a case manager or insurance company representative (usually a nurse) for a person to be admitted to a hospital or in-patient facility, granted prior to the admittance. Pre-admission certification often must be obtained by the individual. Sometimes, however, physicians will contact the appropriate individual. The goal of pre-admission certification is to ensure that individuals are not exposed to inappropriate health care services (services that are medically unnecessary).
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Health / Dentistry / Pre-Admission Certification-Continued Stay Review (PAC-CSR): The process through which the reviewer evaluates the attending physician's request for admission to an acute care hospital and length of stay. Medical necessity is determined using established criteri MORE
Health / Health Insurance / Pre-Admission Review: A review of an individual's health care status or condition, prior to an individual being admitted to an inpatient health care facility, such as a hospital. Pre-admission reviews are often conducted b MORE
Health / Dentistry / Precertification: The process of obtaining certification from the health plan for routine hospital stays or outpatient procedures. The process involves reviewing criteria for benefit coverage determination. MORE