2024 Archdiocese of Atlanta / Lay Employee Quick Guide - Flipbook - Page 26
Meritain Health Medical Management
Through Meritain Health’s Medical Management department, experienced Registered Nurses (RNs) review
certain treatment plans proposed by your physician or healthcare provider.
The Meritain Health Medical Management Nursing Team focuses on:
• The recommended treatment for a health condition.
• The proposed location of the treatment.
• The length of stay at the location.
• The cost-effectiveness of the treatment.
When should you contact the Medical Management Nursing Team?
Pre-Certification
When your physician recommends a treatment from the list below, either you or your physician must contact
Meritain Health Medical Management as soon as possible. If not, your benefits may be reduced.
Call Meritain Health Medical Management:
• At least 24 hours prior to elective, non-emergency admission to a hospital.
• Within 72 hours or three working days after an emergency or urgent hospital admission.
• Prior to elective inpatient surgery (exception: surgery performed in a physician’s office).
• Prior to inpatient mental health disorder treatment.
• Prior to entering an extended care, rehabilitation or skilled nursing facility.
• Prior to beginning chemotherapy treatment.
Meritain Health Medical Management
• 1-866-405-2021
• Available 24 hours a day, seven days a week.
Meritain Health Information Library
You can select from 1,110 up to date, easy to understand
health care topics ranging from allergies to women’s
health on the 24 x 7 Nurse Line.
Many of the topics are provided in both English and
Spanish.
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