Resumption of medical necessity review for inpatient admissions
Customize your policy alerts
Sign up for all meridian_health_plan_of_michigan policy alerts
Know when meridian_health_plan_of_michigan releases new policies or updates existing guidance.
Monitor payer policy activity
Notifies providers that Meridian will resume medical necessity review (prior authorization) for all inpatient admissions effective 07/05/2023 and instructs providers to submit admissions within one business day; affects providers submitting inpatient admission requests to Meridian Health Plan of Michigan.
Meridian Utilization Management will resume medical necessity review for all inpatient admissions, regardless of diagnosis, effective 07/05/2023.
Coverage Criteria
Admission submission requirement
All inpatient admissions require submission for medical necessity review to Meridian Utilization Management.
Admission Criteria (Setting-specific)
SNF | LTACH | IRF | home health | hospice | residential
Admission submission requirement applies to the following post-acute and facility settings.
Provider Actions & Submission Instructions
Submit inpatient admissions to Meridian within one business day for prior authorization review
Submit all inpatient admissions to Meridian Utilization Management for medical necessity review and ensure the admission is sent within one business day.
- Use the Provider Portal: mimeridian.com > Providers > Pre-Auth Check for authorization submissions and portal access.
- For help contact your Provider Network Representative or call 888-773-2647 (TTY 711).
Definitions
OpenPayer is powered by Trek Health's payer performance platform. Trek continuously ingests, validates, and normalizes Transparency in Coverage data alongside payer policies and other commercial payer data to create a structured payer intelligence foundation. OpenPayer uses this foundation to deliver personalized search results, dynamically generated policy pages, and tailored policy monitoring based on each user's payers, specialties, billing codes, and areas of interest. The same intelligence powers broader payer performance workflows, including reimbursement benchmarking, contract evaluation, payer negotiations, and financial decision-making.