Acute Concurrent Review Auto Approval Pilot

By September 14, 2026: Hospital billing and utilization review staff must understand and implement the new auto-approval process for acute concurrent reviews submitted to Telligen. Specific actions: (1) Billing/UR staff should attend at least one of three mandatory training sessions (Sept 2, Sept 10, or Sept 22, 2026) to understand auto-approval triggers and requirements. (2) Ensure all concurrent review submissions include complete clinical documentation using Milliman Care Guidelines for the identified diagnosis—auto-approval depends on this. (3) Update internal workflows to expect Qualitrac notifications of automatic approvals rather than waiting for Telligen nurse decisions. (4) Be aware that CSRs (continued stay reviews) attached to auto-approved concurrent reviews will still be manually reviewed by Telligen nurses, who will verify the original concurrent review documentation justified auto-approval. (5) Understand that Telligen may retroactively deny an auto-approved concurrent review if it later determines medical necessity was not met. Contact Telligen at (888) 276-7075 or MarylandUCSupport@telligen.com with submission questions, or Division of Hospital Services at MDH.AcuteHospitalPolicy@Maryland.gov for policy questions.