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MedicalMediblue Current Process
By vgrass01
Category: Medical. Viewed 794 times. Created August 2013.     Disclaimer.   
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Mediblue Current Process used and how it affects appeals and denials

               
 
 
Clinical faxed to Manila, Phillipines
*Faxing Delays *Failed Faxes
 









 
 
Manila establishes case in system and scans initial clinical to acute team
 
 









 
 
Acute team review
 
 









 
Denial for lack of medical necessity
Site of service denial
Approved *Documentation supported medical necessity *On CNS inpatient list
 









 
Additional clinical faxed or called in to acute team
 
 
 









Approved
Upheld
Additional information not considered due to appeal initiation or communication breakdown
 
 









 
Appeal
Appeal