Participant is eligible for a detox admission for the proposed admit date. If there was no admission with the past 60 days, it will read: Participant is not eligible for a detox admission for the proposed admit date due to a previous inpatient detoxification stay within 60 days. If there was an admission within the past 60 days, the message will read: If hospital staff needs access to eQSuite™, they should contact their eQHealth Web Administrator.
This utility will be available solely through eQHealth’s Web system, eQSuite™, as it offers 24/7 availability and a majority of providers already have access to eQSuite™. The admitting inpatient facility should contact eQHealth within 24 hours or the next business day of the admission to begin the concurrent review process.Įffective July 9, 2012, a Detoxification Look-Up utility will be available to providers to check inpatient detoxification admission status. Inpatient detoxification admission stays will not be approved for reimbursement if there has been a previous inpatient detoxification stay within the last 60 days. As a result of Public Act 097-0689 (pdf), referred to as the Save Medicaid Access and Resources Together (SMART) Act, the department is implementing the following utilization review changes specific to inpatient level of care for detoxification readmissions.Įffective with admissions on or after July 9, 2012, HFS will implement a review of inpatient detoxification admissions 60 days prior to July 9, 2012, for the detoxification diagnosis codes that currently require mandatory concurrent review and are identified below.
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