Visio - Admission to NF SNF

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Texas Health Care Association

Admission to NF/SNF
Clinical Review Appropriateness
including PASRR
Inform referral source and
recommend alternatives
Payor Benefits and Eligibility
CWF Review
(Medicare Remote)
Prior Authorization/
Pre-Certification if required
1) Appeal?
2) Inform Referral Source and Responsible Party
3) Offer alternatives
Denied
Determine 2nd
Payor if any
Approved
Approved
Admit
Denied

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