TJC category
Reimbursement Payment
Payment, reimbursement, rate, claim, and payment-method provisions.
Cascade
Source collection
TJC
Category group
Payment Program Integrity
Category
Reimbursement Payment
Grouped by instrument
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Instruments
1
Shown
1
Citation
TJC LD.13.01.03
In Reimbursement PaymentQuality Governance
For hospitals that use Joint Commission accreditation for deemed status purposes:
The hospital must maintain a utilization review plan and committee to ensure the medical necessity of services provided to Medicare and Medicaid patients.
Group
Payment Program Integrity
Category
Reimbursement Payment
Domain
Billing Reimbursement
Topics
Utilization review plan, Medical necessity determination