{"id":165,"date":"2022-10-03T09:16:38","date_gmt":"2022-10-03T16:16:38","guid":{"rendered":"https:\/\/goldenbayhp.wpengine.com\/?page_id=165"},"modified":"2023-12-26T10:24:20","modified_gmt":"2023-12-26T18:24:20","slug":"um","status":"publish","type":"page","link":"https:\/\/gbhp.org\/es\/for-providers\/um\/","title":{"rendered":"M.U."},"content":{"rendered":"<div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-1 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"background-color: rgba(255,255,255,0);background-position: center center;background-repeat: no-repeat;border-width: 0px 0px 0px 0px;border-color:var(--awb-color3);border-style:solid;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start\" style=\"max-width:1248px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-0 fusion_builder_column_1_1 1_1 fusion-flex-column\"><div class=\"fusion-column-wrapper fusion-flex-justify-content-flex-start fusion-content-layout-column\" style=\"background-position:left top;background-repeat:no-repeat;-webkit-background-size:cover;-moz-background-size:cover;-o-background-size:cover;background-size:cover;padding: 0px 0px 0px 0px;\"><div class=\"fusion-text fusion-text-1\"><p><strong>Plan de salud de Golden Bay<\/strong> delega el procesamiento de solicitudes de autorizaci\u00f3n previa a <strong>Organizaci\u00f3n de servicios de gesti\u00f3n de servicios m\u00e9dicos del noreste<\/strong> (NEMS MSO). Todas las decisiones de UM se basan en la cobertura de beneficios del miembro y la idoneidad de los servicios.<\/p>\n<h5>Disponibilidad del personal de la UM<\/h5>\n<p>El personal de NEMS MSO UM est\u00e1 disponible para los miembros y proveedores durante el horario comercial habitual (de lunes a viernes, de 8:00 a. m. a 5:30 p. m.) llamando al <a href=\"tel:14153525186\"><strong>1(415) 352-5186<\/strong><\/a>Opci\u00f3n 1. Para analizar cuestiones de UM y decisiones de denegaci\u00f3n, o para solicitar una copia de las pol\u00edticas, procedimientos y criterios de UM, llame al <a href=\"tel:14153525186\"><strong>1(415) 352-5186<\/strong><\/a>Opci\u00f3n 1. Despu\u00e9s del horario laboral normal, el personal de UM puede recibir correo de voz seguro y fax. Env\u00ede por fax cualquier documento relacionado con UM a la l\u00ednea de fax de UM de NEMS MSO <strong>1(415) 398-2895<\/strong>.<\/p>\n<h5>Presentaci\u00f3n de solicitudes de autorizaci\u00f3n previa<\/h5>\n<p>Todas las solicitudes de autorizaciones previas y la documentaci\u00f3n cl\u00ednica de respaldo pueden enviarse por fax a la l\u00ednea de fax de NEMS MSO UM a <strong>1(415) 398-2895<\/strong> o a trav\u00e9s de la <a href=\"https:\/\/eznet.nems.org\/EZ-NET60\/Login.aspx\" target=\"_blank\" rel=\"noopener\"><strong>Portal de proveedores NEMS MSO (EZ-NET)<\/strong><\/a>.<\/p>\n<\/div><div class=\"fusion-builder-row fusion-builder-row-inner fusion-row fusion-flex-align-items-flex-start\" style=\"width:104% !important;max-width:104% !important;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-0 fusion_builder_column_inner_1_6 1_6 fusion-flex-column\"><div class=\"fusion-column-wrapper fusion-flex-justify-content-flex-start fusion-content-layout-column\" style=\"background-position:left top;background-repeat:no-repeat;-webkit-background-size:cover;-moz-background-size:cover;-o-background-size:cover;background-size:cover;padding: 0px 0px 0px 0px;\"><\/div><style type=\"text\/css\">.fusion-body .fusion-builder-nested-column-0{width:16.6666666667% !important;margin-top : 0px;margin-bottom : 0px;}.fusion-builder-nested-column-0 > .fusion-column-wrapper {padding-top : 0px !important;padding-right : 0px !important;margin-right : 11.52%;padding-bottom : 0px !important;padding-left : 0px !important;margin-left : 11.52%;}@media only screen and (max-width:1024px) {.fusion-body .fusion-builder-nested-column-0{width:16.6666666667% !important;order : 0;}.fusion-builder-nested-column-0 > .fusion-column-wrapper {margin-right : 11.52%;margin-left : 11.52%;}}@media only screen and (max-width:640px) {.fusion-body .fusion-builder-nested-column-0{width:100% !important;order : 0;}.fusion-builder-nested-column-0 > .fusion-column-wrapper {margin-right : 1.92%;margin-left : 1.92%;}}<\/style><\/div><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-1 fusion_builder_column_inner_1_3 1_3 fusion-flex-column\"><div class=\"fusion-column-wrapper fusion-flex-justify-content-flex-start fusion-content-layout-column\" style=\"background-position:left top;background-repeat:no-repeat;-webkit-background-size:cover;-moz-background-size:cover;-o-background-size:cover;background-size:cover;padding: 0px 0px 0px 0px;\"><div ><style>.fusion-body .fusion-button.button-1{border-radius:0 0 0 0;}<\/style><a class=\"fusion-button button-flat button-xlarge button-default button-1 fusion-button-default-span fusion-button-default-type\" target=\"_blank\" rel=\"noopener noreferrer\" href=\"https:\/\/eznet.nems.org\/EZ-NET60\/Login.aspx\"><i class=\"fa-database fas button-icon-left\" aria-hidden=\"true\"><\/i><span class=\"fusion-button-text\">Portal de proveedores de MSO de NEMS<\/span><\/a><\/div><\/div><style type=\"text\/css\">.fusion-body .fusion-builder-nested-column-1{width:33.3333333333% !important;margin-top : 0px;margin-bottom : 10px;}.fusion-builder-nested-column-1 > .fusion-column-wrapper {padding-top : 0px !important;padding-right : 0px !important;margin-right : 5.76%;padding-bottom : 0px !important;padding-left : 0px !important;margin-left : 5.76%;}@media only screen and (max-width:1024px) {.fusion-body .fusion-builder-nested-column-1{width:33.3333333333% !important;order : 0;}.fusion-builder-nested-column-1 > .fusion-column-wrapper {margin-right : 5.76%;margin-left : 5.76%;}}@media only screen and (max-width:640px) {.fusion-body .fusion-builder-nested-column-1{width:100% !important;order : 0;}.fusion-builder-nested-column-1 > .fusion-column-wrapper {margin-right : 1.92%;margin-left : 1.92%;}}<\/style><\/div><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-2 fusion_builder_column_inner_1_3 1_3 fusion-flex-column\"><div class=\"fusion-column-wrapper fusion-flex-justify-content-flex-start fusion-content-layout-column\" style=\"background-position:left top;background-repeat:no-repeat;-webkit-background-size:cover;-moz-background-size:cover;-o-background-size:cover;background-size:cover;padding: 0px 0px 0px 0px;\"><div ><style>.fusion-body .fusion-button.button-2{border-radius:0 0 0 0;}<\/style><a class=\"fusion-button button-flat button-xlarge button-default button-2 fusion-button-default-span fusion-button-default-type\" target=\"_blank\" rel=\"noopener noreferrer\" href=\"https:\/\/nemsmso.org\/wp-content\/uploads\/Treatment_Authorization_Form-112023_fillable.pdf\"><i class=\"fa-file-pdf fas button-icon-left\" aria-hidden=\"true\"><\/i><span class=\"fusion-button-text\">Formulario de solicitud de autorizaci\u00f3n<\/span><\/a><\/div><\/div><style type=\"text\/css\">.fusion-body .fusion-builder-nested-column-2{width:33.3333333333% !important;margin-top : 0px;margin-bottom : 0px;}.fusion-builder-nested-column-2 > .fusion-column-wrapper {padding-top : 0px !important;padding-right : 0px !important;margin-right : 5.76%;padding-bottom : 0px !important;padding-left : 0px !important;margin-left : 5.76%;}@media only screen and (max-width:1024px) {.fusion-body .fusion-builder-nested-column-2{width:33.3333333333% !important;order : 0;}.fusion-builder-nested-column-2 > .fusion-column-wrapper {margin-right : 5.76%;margin-left : 5.76%;}}@media only screen and (max-width:640px) {.fusion-body .fusion-builder-nested-column-2{width:100% !important;order : 0;}.fusion-builder-nested-column-2 > .fusion-column-wrapper {margin-right : 1.92%;margin-left : 1.92%;}}<\/style><\/div><div class=\"fusion-layout-column fusion_builder_column_inner fusion-builder-nested-column-3 fusion_builder_column_inner_1_6 1_6 fusion-flex-column\"><div class=\"fusion-column-wrapper fusion-flex-justify-content-flex-start fusion-content-layout-column\" style=\"background-position:left top;background-repeat:no-repeat;-webkit-background-size:cover;-moz-background-size:cover;-o-background-size:cover;background-size:cover;padding: 0px 0px 0px 0px;\"><\/div><style type=\"text\/css\">.fusion-body .fusion-builder-nested-column-3{width:16.6666666667% !important;margin-top : 0px;margin-bottom : 0px;}.fusion-builder-nested-column-3 > .fusion-column-wrapper {padding-top : 0px !important;padding-right : 0px !important;margin-right : 11.52%;padding-bottom : 0px !important;padding-left : 0px !important;margin-left : 11.52%;}@media only screen and (max-width:1024px) {.fusion-body .fusion-builder-nested-column-3{width:16.6666666667% !important;order : 0;}.fusion-builder-nested-column-3 > .fusion-column-wrapper {margin-right : 11.52%;margin-left : 11.52%;}}@media only screen and (max-width:640px) {.fusion-body .fusion-builder-nested-column-3{width:100% !important;order : 0;}.fusion-builder-nested-column-3 > .fusion-column-wrapper {margin-right : 1.92%;margin-left : 1.92%;}}<\/style><\/div><\/div><div class=\"fusion-text fusion-text-2\"><h5>Tiempo de respuesta de TAR<\/h5>\n<p>El tiempo est\u00e1ndar para procesar autorizaciones previas es el siguiente:<\/p>\n<\/div>\n<div class=\"table-1\" style=\"margin-bottom:25px;\">\n<table width=\"100%\">\n<thead>\n<tr>\n<th align=\"left\"><\/th>\n<th align=\"left\">M\u00e9dico<\/th>\n<th align=\"left\">Seguro m\u00e9dico del estado<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td align=\"left\">Solicitudes de rutina<\/td>\n<td align=\"left\">Cinco (5) d\u00edas h\u00e1biles<\/td>\n<td align=\"left\">Catorce (14) d\u00edas naturales<\/td>\n<\/tr>\n<tr>\n<td align=\"left\">Solicitudes urgentes<\/td>\n<td align=\"left\">Dentro de las setenta y dos (72) horas siguientes a su recepci\u00f3n<\/td>\n<td align=\"left\">Dentro de las setenta y dos (72) horas siguientes a su recepci\u00f3n<\/td>\n<\/tr>\n<tr>\n<td align=\"left\">Solicitudes retrospectivas<\/td>\n<td align=\"left\">Treinta (30) d\u00edas naturales a partir de la fecha de recepci\u00f3n<\/td>\n<td align=\"left\">No aceptado para Medicare<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n<div class=\"fusion-text fusion-text-3 fusion-text-no-margin\" style=\"margin-bottom:0px;\"><p>Para obtener m\u00e1s informaci\u00f3n, visite el sitio <a href=\"https:\/\/www.nemsmso.org\/prior-authorizations\/\" target=\"_blank\" rel=\"noopener\"><strong>Sitio web de NEMS MSO<\/strong><\/a>.<\/p>\n<\/div><\/div><style type=\"text\/css\">.fusion-body .fusion-builder-column-0{width:100% !important;margin-top : 0px;margin-bottom : 20px;}.fusion-builder-column-0 > .fusion-column-wrapper {padding-top : 0px !important;padding-right : 0px !important;margin-right : 1.92%;padding-bottom : 0px !important;padding-left : 0px !important;margin-left : 1.92%;}@media only screen and (max-width:1024px) {.fusion-body .fusion-builder-column-0{width:100% !important;order : 0;}.fusion-builder-column-0 > .fusion-column-wrapper {margin-right : 1.92%;margin-left : 1.92%;}}@media only screen and (max-width:640px) {.fusion-body .fusion-builder-column-0{width:100% !important;order : 0;}.fusion-builder-column-0 > .fusion-column-wrapper {margin-right : 1.92%;margin-left : 1.92%;}}<\/style><\/div><\/div><style type=\"text\/css\">.fusion-body .fusion-flex-container.fusion-builder-row-1{ padding-top : 0px;margin-top : 0px;padding-right : 0px;padding-bottom : 0px;margin-bottom : 0px;padding-left : 0px;}<\/style><\/div>","protected":false},"excerpt":{"rendered":"","protected":false},"author":2,"featured_media":0,"parent":70,"menu_order":2,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-165","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/gbhp.org\/es\/wp-json\/wp\/v2\/pages\/165","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/gbhp.org\/es\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/gbhp.org\/es\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/gbhp.org\/es\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/gbhp.org\/es\/wp-json\/wp\/v2\/comments?post=165"}],"version-history":[{"count":0,"href":"https:\/\/gbhp.org\/es\/wp-json\/wp\/v2\/pages\/165\/revisions"}],"up":[{"embeddable":true,"href":"https:\/\/gbhp.org\/es\/wp-json\/wp\/v2\/pages\/70"}],"wp:attachment":[{"href":"https:\/\/gbhp.org\/es\/wp-json\/wp\/v2\/media?parent=165"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}