- Joined
- Jul 8, 2007
- Messages
- 190
- Reaction score
- 66
Has anyone worked for a managed medicare company like Humana or United doing to review for approval to IPR. I do peer to peers all the time and i swear its luck of the draw on getting patients approved for transfer from acute to ipr. The constant thing i hear is “they dont fit medicare criteria for ipr”. I know the basics and when i ask which criteria they never will say specifics. Just usually the same line about not fitting over and over. If they elaborate at all they just say the person doesnt need a pmr doctor and they recommend snf. Id love to know the specifics of the criteria or list they have to go off for their decisions.