Office of Managed Care Operations

What does each UH contract include/exclude

Inpatient

All services include except where noted- eg. Cosmetic surgery, mental health, special appliances, provision of blood, military service related problems, experimental procedures,etc.

Outpatient

Some HMOs will not pay for lab, radiology, and rehabilitation.

ER

	HMOs must pay screening fee
	HMOs will pay for "Emergency Care"
	HMOs will not pay for non-medical emergencies beyond the screening fee unless they have a tiered payment schedule for levels of care.

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Last Reviewed: August 2008
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University Hospital
150 Bergen Street
Newark, NJ 07103 USA
(973) 972 - 4300