Kern Health Systems (KHS) is a Medi-Cal Managed Care Plan, which operates in Kern County, California and is required to provide all non-contracting hospitals in the State of California with contact information needed to request authorization for post stabilization care when a KHS member receives emergency medical care from a non-contracting hospital. KHS does not require prior authorization approval for Emergent and the initial post-stabilization admission services. KHS does require notification from non-contracted hospitals following a post-stabilization admission for ongoing treatment authorization as follows:
- We must receive the admission notification within 24 hours after an actual weekday admission (or by 5 p.m. local time on the next business day if 24-hour notification would require notification on a weekend or holiday).
- For weekend and holiday admissions, we must receive the notification by 5 p.m. local time on the next business day.
Notification may be done by calling the Utilization Management (UM) Department directly at 661-664-5083 during business hours from 8:00 a.m. to 5:00 p.m. to speak with a hospital concurrent review staff member.
Or you may fax the notification to 661-664-5169 along with the member’s hospital face sheet.
Upon receipt of the notification the KHS UM Department will respond within 24 hours with a tracking number and to initiate ongoing medical necessity concurrent review and discharge planning.
Once you have obtained the tracking number, fax the clinical information to 661-664-5169 to support your request to a concurrent review nurse case manager using the fax number that was provided to you along with the tracking number. Please include your contact information (name, phone number, and fax number).