|Division |Product |Reason Codes |
|STM Gatekeeper |Medicare |0373 – Notification on File, Units Maxed (provider liability) |
| | |1068 – Requires Referral, Gatekeeper Plan (provider liability) |
| | |1081 – Requires Referral, Gatekeeper Plan (provider liability) |
Revision History
|Date Revised |Page #s |Revision |Author Initials |
|07/19/2013 |8 |Steps 1 and 2: Added, renumbered subsequent steps |GCB |
|05/20/2013 |5 |Table: Updated |TAS |
| |15 |Appendix: Deleted | |
|05/10/2013 |1 |Division, STM HMO2: Deleted |KJS |
| |2 |Overview, Determine if the referring Physician is Contracted or | |
| | |Non-contracted: Deleted | |
| |8 |Step 2: Updated | |
| | |Step 3: Deleted; renumbered subsequent steps | |
|...