83 Precertification includes the analysis & determination Appropriate level of of which of the following (may check [] all that care (e.g., IP vs. OP) apply). Reasonable length of stay of IP confinement Actual medical necessity & appropriateness of surgery or service being requested (e.g., does service require performance?) Necessity for the services of an assistant surgeon with each operative procedure analysis Necessity for a proposed preoperative hospital day Necessity for a proposed 23-hour observation stay following OP surgery Other (Explain) Does your firm perform concurrent review services? Yes No 84 85 Concurrent review staff are: New Mexico employees only National (Non NM employees) Combination NM & Non NM 86 Do you subcontract catastrophic case management Yes No services? 87 During case management, does your staff negotiate Yes No fee reductions with providers and vendors? 88 Catastrophic case management are: New Mexico employees only National (Non NM employees) Combination NM & Non NM
83 Precertification includes the analysis & determination of which of the following (may check [] all that apply). Appropriate level of care (e.g., IP vs. OP) Reasonable length of stay of IP confinement Actual medical necessity & appropriateness of surgery or service being requested (e.g., does service require performance?) Necessity for the services of an assistant surgeon with each operative procedure analysis Necessity for a proposed preoperative hospital day Necessity for a proposed 23-hour observation stay following OP surgery Other (Explain) 84 Does your firm perform concurrent review services? Yes No 85 Concurrent review staff are: New Mexico employees only National (Non NM employees) Combination NM & Non NM 86 Do you subcontract catastrophic case management services? Yes No 87 During case management, does your staff negotiate fee reductions with providers and vendors? Yes No 88 Catastrophic case management are: New Mexico employees only National (Non NM employees) Combination NM & Non NM