Does anyone know the Interqual Standards for Level of Care for insurance providers? or where I can find them??

Question

These are standards for medical insurance companies to accept or deny medical claims to pay damages when a hospital stay occurs. I need to know if anyone knows the standards they use for "level of care" aka Medical Necessity claims....anyone???

Answer 1

It's not static, so you're not going to find a "one size fits all" list.

Each company will have a standard for each plan they offer - in other words, there can be different standards within the same company, based on which plan, and which state the insured is in.

Answer 2

Go here..

http://www.interqual.com/IQSite/products...

and, what levels? I can't define them all... Mental or medical?