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)
Available Credit
- 0.00 Attendance