2 - Health Services Review

The term "health services review" identifies a notification of authorization for specific treatments or more extended care. Extended care refers to treatment for a condition requiring prolonged rehabilitation therapy. This transaction set supports a notification for authorization of services related to specific treatment or extended care associated with a single patient event. Complex treatment plans represent multiple patient events. Use a separate notification transaction for each patient event.

This is an example of a notification indicating a certified in total decision for chiropractic services of the spine. The UMO is notifying the chiropractor that it has authorized 24 visits to occur twice per week over a (3) month period.