Clinical Review Guides
As a provider working with managed care patients, you are asked to participate in a clinic review process. In order to expedite the review process, be sure to review applicable Cigna’s Medical Necessity Criteria expectations for admission, continued stay and discharge. Please note, the information asked in a review can vary depending on the level of care requested as well the diagnosis of the patient. Below are the various outlines Cigna care managers could utilize during the review process.
Inpatient Review Outline
Inpatient Concurrent Review Outlines
- C&A Higher Level of Care
- Eating DO Higher Level of Care
- General Higher Level of Care
- SA Higher Level of Care