Manndatory Hospitalization Utilization Program Through Intracorp

The Board of Trustees implemented a new mandatory hospitalization utilization program for this Trust Fund effective January 1, 2001. This applies to all active employees, retirees not covered by Medicare, spouses and dependents. You should have received an Intracorp ID card. You should carry your card with you at all times since it contains the toll free Intracorp phone number.

WHEN TO CALL INTRACORP:
For any non-emergency inpatient hospital admission for a condition or surgery you must call at least twenty (20) calendar days before you are admitted. Failure to comply shall result in a reduction of benefits by 20% up to a maximum of $500.00 per admission.

For an emergency inpatient hospital admission for a condition or surgery you have 48 hours to notify Intracorp. If you are unable to call, a family member, friend, your doctor or the hospital may call for you. Failure to comply shall result in a reduction of benefits by 20% up to a maximum of $500.00 per admission.

For an inpatient hospital admission for maternity you should call as soon as you begin to receive maternity care, but you must call no later than 3 months before the expected delivery date. You must call again within 48 hours of delivery. Patients who are already pregnant when they become eligible under the Plan need to notify Intracorp with in 30 days of their effective date of coverage. Failure to comply shall result in a reduction of benefits by 10% up to a maximum of $200.00.

WHEN YOU CALL INTRACORP YOU SHOULD BE PREPARED TO PROVIDE THE FOLLOWING INFORMATION:
You should be prepared to give the clinical assistant the following information:

Patient’s name, address, phone number and date of birth.
Employee’s name and social security number.
The admitting doctor’s name, address and phone number.
Hospital name, address and phone number where care is to be received.
The admission date and reason (if known).

A six digit case number is given for each hospital admission at the time of the call. Please retain this number for future reference until your case is closed. After the call is completed and Intracorp has received the necessary information from you and the doctor, a letter shall be sent to you with important information regarding your admission to the hospital. Please note that certification with Intracorp does not guarantee payment of benefits. Intracorp cannot verify eligibility or give benefits. Intracorp ONLY reviews the length of stay in the hospital, medical necessity for admission and medical appropriateness of the facility. Benefits payable under your health plan will be determined at the time the claim is received by Group Benefit Administrators. Benefits are based on eligibility and plan provisions in effect at the time of service.

HOW TO CONTACT INTRACORP:
For a medical admission call toll free: 1-800-423-2221
For a mental health admission call toll free: 1-800-338-9059

Regular business hours are Monday through Friday between 6:30 a.m. and 6:00 p.m. Mountain Standard Time. If you call during non-business hours you will get a voice activated system at which time you can leave a message and your call will be returned during regular business hours. Their toll free number is in operation 24 hours a day, 365 days a year.

The Purpose of calling Intracorp:
To review the length of stay in the hospital to determine if number of days the patient will be admitted for is appropriate for the condition or surgery.

To determine the medical necessity of an inpatient admission for the condition or surgery. Benefits shall be reduced by 100% if inpatient care is obtained when outpatient care is recommended.

If the Intracorp doctor does not agree with the type of treatment, then your doctor has the right to consult with another Intracorp physician of the same specialty. If the treatment is not medically necessary, then there shall be no payment for benefits under the Plan.

If you have any questions concerning pre-certification for inpatient hospital admissions with Intracorp please contact the administrative office at:
(801) 972-1177 or 1-800-657-5377.

The Board of Trustees thank you for your cooperation and we look forward to working with you and making this program effective in order to assure that your benefits continue for many years to come.