Managed Care

The policies and forms on this page are used by Christian Science nursing facilities that are members of the Christian Science Provider Network (CSPN) to determine whether the criteria for coverage of services under managed care health plans (including Medicare Advantage plans) are satisfied.  These policies were developed from the statutes and regulations governing Medicare generally and the Medicare Advantage program in particular, similar policies and procedures relating to coverage of hospital and skilled nursing facility services, and health plan experts’ input.  If you have questions or comments about these forms, please contact us.

Click on the policy or form below to print or click in the side bar. 

ACUTE PRECERTIFICATION POLICY

     Preadmission-Acute Pre-Cert form

 ACUTE UTILIZATION MANAGEMENT POLICY

     Acute Utilization Management Form

SNF PRECERTIFICATION POLICY

     Preadmission-SNF Pre-Cert form

SNF UTILIZATION MANAGEMENT POLICY

     SNF Utilization Management Form