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Search Results For : " UNIVERSITY OF BIRMINGHAMBIRMIN "

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Provider Resources - Utilization Management Criteria

e. IEHP has created UM Subcommittee Approved Authorization Guidelines to serve as one of the sets of criteria for medical necessity decisions. Our goal in creating this page is to provide you with easily accessible electronic versions of IEHP’s UM guidelines. IEHP utilizes a variety of sources in developing our UM guidelines which include: Medicare and Medi-Cal’s coverage policy statements Evidence in the peer-reviewed published medical literature Technology assessments and structured evidence reviews Evidence-based consensus statements Expert opinions of healthcare Providers Evidence-based guidelines from nationally recognized professional healthcare organizations and public health agencies. IEHP is also licensed to use MCG Guidelines, Apollo Medical Review Criteria, and InterQual to guide in utilization management decisions. Since medical technology is constantly evolving, our clinical guidelines are subject to change without prior notification. Additional UM Subcommittee Guidelines may be developed as needed or may be withdrawn from use. Please note that benefits may vary based on Member’s line of business; therefore, certain services discussed in the UM Subcommittee Guidelines may not be a covered benefit. Table of Contents (PDF) Providers may obtain information about criteria, either in general or relating to specific UM decisions, from IEHP upon request by contacting the IEHP UM Department. Please contact the IEHP Provider Relations Team at (909) 890-2054 to be connected to the UM Department.  Behavioral Health Behavioral Health Treatment (BHT) Criteria (PDF) Criteria for Multidisciplinary Diagnostic Treatment (PDF) Community Supports Services Community Transition Services Nursing Facility Transition to a Home (PDF) Nursing Facility Transition-Diversion to Assisted Living (PDF) Housing Deposits (PDF) Housing Transition Navigation Services (PDF) Housing Tenancy and Sustaining Services (PDF) Asthma Remediation (PDF) Environmental Accessibility Adaptations (Home Modifications) (PDF) Medically Tailored Meals (PDF) Sobering Centers (PDF) Recuperative Care (PDF) Short-Term Post-Hospitalization Housing (PDF) Day Habilitation Programs (PDF) Respite Services (PDF) Personal Care and Homemaker Services (PDF) Diagnostic Testing Elastography (PDF) Inflammatory Bowel Disease Serology (PDF) Vestibular Autorotation Test (PDF) Gynecology and Obstetrics Fetal Non-Stress Testing (PDF) Neurology Bone Marrow Transplant in Treatment of Multiple Sclerosis (PDF) Pain Management Referrals to Pain Management Specialist (PDF) Pharmacy Biosimilar Products (PDF) CAR-T Therapy (PDF) Surgical Procedures Adolescent Bariatric Consultation and Surgery (PDF) Natural Orifice Transluminal Endoscopic Surgery (PDF) Other Allocation of Limited Critical Care Resources During a Public Health Emergency (PDF) Complementary and Alternative Medicine or Holistic Therapies (PDF) Congregate Living Health Facilities (PDF) Criteria for Custodial Care: Medi-Cal (PDF) Enhanced Care Management (PDF) Hair Removal Guideline (PDF) My Path (A Palliative Care Approach) (PDF) Tertiary Care Center Referral Requests (PDF) Transitional Care Medicine (PDF) Transportation Criteria (PDF)   You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.

Upcoming Events - Becoming a Mom: You and Your Pregnancy (San Bernardino)

participants will learn what they can do to have a healthy pregnancy and some of the common discomforts that come with pregnancy. Click here to register for this in-person class Location IEHP Community Resource Center (San Bernardino) 805 W 2nd St San Bernardino, CA 92410

Upcoming Events - Healthy Heart (Online): Knowledge is Power + React in Time to Heart Attack Signs (Online)

l understand how the heart works and lifestyle changes for a healthy heart. We will also be discussing early signs of a heart attack and how to prevent a heart attack.  Click here to register for this Webex class   Session Number:  26310238435 Download Webex for Apple users Download Webex for Android users Download Webex for PC users

Upcoming Events - Understanding Diabetes: Taking Medication (Riverside)

is necessary for some people and how different types of medicines help manage diabetes. Click here to register for this in-person class Location IEHP Community Resource Center (Riverside) 3590 Tyler St Riverside, CA 92503

Upcoming Events - Healthy Heart : Get Energized! Say Yes to Physical Activity + Control Your Blood Pressure (Riverside)

earn about different types of physical activities to improve heart health as well as learn how to control your blood pressure.  Click here to register for this in-person class Location IEHP Community Resource Center (Riverside) 3590 Tyler St Riverside, CA 92503

Upcoming Events - Becoming a Mom: Stress During Pregnancy (San Bernardino)

importance of reducing stress and being active during your pregnancy. Click here to register for this in-person class Location IEHP Community Resource Center (San Bernardino) 805 W 2nd St San Bernardino, CA 92410

Upcoming Events - Healthy Heart (Online): Knowledge is Power + React in Time to Heart Attack Signs (Online)

derstand how the heart works and lifestyle changes for a healthy heart. We will also be discussing early signs of a heart attack and how to prevent a heart attack.  Click here to register for this Webex class   Session Number:  26328620505 Download Webex for Apple users Download Webex for Android users Download Webex for PC users

Upcoming Events - Healthy Heart (Online): Get Energized! Say Yes to Physical Activity + Control Your Blood Pressure (Online)

ll learn about different types of physical activities to improve heart health as well as learn how to control your blood pressure.  Click here to register for this Webex class   Session Number:  26328233246 Download Webex for Apple users Download Webex for Android users Download Webex for PC users

Upcoming Events - Becoming a Mom: You and Your Pregnancy (Victorville)

lass participants will learn what they can do to have a healthy pregnancy and some of the common discomforts that come with pregnancy.  Click here to register for this in-person class Location IEHP Community Resource Center (Victorville) 12353 Mariposa Rd Suites C-2 & C-3 Victorville, CA 92395

Upcoming Events - Healthy Heart (Online): Get Energized! Say Yes to Physical Activity + Control Your Blood Pressure (Online)

learn about different types of physical activities to improve heart health as well as learn how to control your blood pressure.  Click here to register for this Webex class   Session Number:  26306819732 Download Webex for Apple users Download Webex for Android users Download Webex for PC users

Upcoming Events - Understanding Diabetes: Problem Solving (Riverside)

ize symptoms of low and high blood sugar levels, how to treat them, and how to prevent them. Also, learn to manage blood sugar levels when you get sick. Click here to register for this in-person class Location IEHP Community Resource Center (Riverside) 3590 Tyler St Riverside, CA 92503

Upcoming Events - Understanding Diabetes: Taking Medication (Riverside)

e is necessary for some people and how different types of medicines help manage diabetes. Click here to register for this in-person class Location IEHP Community Resource Center (Riverside) 3590 Tyler St Riverside, CA 92503

Upcoming Events - Eat Healthy, Be Active Workshop (Victorville)

rn how to eat healthy on a budget, how to make healthy selections when dining out, and it also reviews the importance of physical activity. Click here to register for this in-person class Location IEHP Community Resource Center (Victorville) 12353 Mariposa Rd Suites C-2 & C-3 Victorville, CA 92395

Upcoming Events - Becoming a Mom: Prenatal Care (San Bernardino)

ants will learn about the importance of getting early and regular prenatal care. Click here to register for this in-person class Location IEHP Community Resource Center (San Bernardino) 805 W 2nd St San Bernardino, CA 92410

Upcoming Events - Becoming a Mom: Prenatal Care (San Bernardino)

ipants will learn about the importance of getting early and regular prenatal care. Click here to register for this in-person class Location IEHP Community Resource Center (San Bernardino) 805 W 2nd St San Bernardino, CA 92410

Upcoming Events - Understanding Diabetes (Online)

ise impacts blood sugar, different types of exercise, and addressing barriers to exercise.  Click here to register for this Webex class   Session Number: 26341083491 Download Webex for Apple users Download Webex for Android users Download Webex for PC users

Upcoming Events - Healthy Heart : Knowledge is Power + React in Time to Heart Attack Signs (San Bernardino)

nderstand how the heart works and lifestyle changes for a healthy heart. We will also be discussing early signs of a heart attack and how to prevent a heart attack.  Click here to register for this in-person class Location IEHP Community Resource Center (San Bernardino) 805 W 2nd St San Bernardino, CA 92410

Upcoming Events - Becoming a Mom: Stress During Pregnancy (San Bernardino)

mportance of reducing stress and being active during your pregnancy. Click here to register for this in-person class Location IEHP Community Resource Center (San Bernardino) 805 W 2nd St San Bernardino, CA 92410

Upcoming Events - Becoming a Mom: You and Your Pregnancy (San Bernardino)

ass participants will learn what they can do to have a healthy pregnancy and some of the common discomforts that come with pregnancy.  Click here to register for this in-person class Location IEHP Community Resource Center (San Bernardino) 805 W 2nd St San Bernardino, CA 92410

Upcoming Events - Healthy Heart : Knowledge is Power + React in Time to Heart Attack Signs (San Bernardino)

l understand how the heart works and lifestyle changes for a healthy heart. We will also be discussing early signs of a heart attack and how to prevent a heart attack.  Click here to register for this in-person class Location IEHP Community Resource Center (San Bernardino) 805 W 2nd St San Bernardino, CA 92410