UM013-OCMM Peer-to-Peer Process

NEW HIRE  ORIENTATION

This course focuses on Peer process including Peer-to-peer timeframes, when a change in determination is allowable, proper documentation.

Target Audience

 

Optum Care Management

Utilization Management

Medicare

Medical Director

Inpatient

Prior Authorization

Learning Objectives

 

Identify the need for a Peer-to-Peer (P2P) review.

Apply OptumCare procedure when conducting a P2P review.

Implement P2P timeframe requirements.

 

MATERIAL INFORMATION

Peer to Peer Process for IP Medical Director (SOP)

Inpatient Medical Director Determination Workflow (SOP)

Prior Auth Peer-to-Peer Process (SOP)

Clinical MCG Care Guidelines Requirements (SOP)

Peer-to-Peer Communication with Providers (JA)

Prior Auth Determination Templates -Medicare (JA)

Course summary
Available credit: 
  • 0.00 Attendance
Course opens: 
10/28/2020
Course expires: 
10/28/2022
Cost:
$0.00

Available Credit

  • 0.00 Attendance

Price

Cost:
$0.00
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