FLASH: Updated Inpatient Peer-to-Peer (P2P) Process – Effective Immediately

Due to the health plan closure and associated staff reductions, we are implementing a revised Peer-to-Peer (P2P) process to ensure timely and appropriate clinical reviews.

If the member has not been discharged:

• A Peer-to-Peer (P2P) review can be arranged between the attending provider and the health plan physician.

If the member has been discharged:

• A formal appeal must be initiated.
• Peer-to-Peer reviews are not available post-discharge.