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Inpatient Hospital Certification

Paramount’s Inpatient Hospital Certification process is designed to make sure that all hospital admissions are medically appropriate and that the care given to our members is being provided in the correct setting. To determine whether the care is appropriate, we use InterQuals’ Level of Care criteria, along with clinical judgement. These criteria also help us assess the medical necessity of continued stay for our members. Do you have questions about the criteria that we use to establish medical necessity? Our providers are always encouraged to contact the Utilization Management Department at 419-887-2520 or 1-800-891-2520 for more information about inpatient hospital certification.

During an inpatient hospital stay, Paramount’s transition of care team will assess for post stabilization needs. Appropriate services will be arranged through participating providers.