FUM: Follow-Up After Emergency Department Visit for Mental Illness
7-day and 30-day MH outpatient follow-up after ED.
Measure description
7-day and 30-day MH outpatient follow-up after ED.
Eligible population
Members with ED visit for MH
Performance drivers
ED MH visits drive future hospitalizations without follow-up.
Documentation & PA strategy
Warm handoff + scheduled appointment before ED discharge.
Why HEDIS matters for prior authorization
Health plans align prior authorization criteria with HEDIS measures: documenting your patient meets the HEDIS definition often streamlines or eliminates PA hurdles. For Medicare Advantage in particular, plans are heavily incentivized via Star Ratings to push members and providers toward measure compliance, which translates into faster approvals for measure-aligned services.
Frequently asked questions
What does HEDIS measure FUM measure?
7-day and 30-day MH outpatient follow-up after ED.
What drives performance on this measure?
ED MH visits drive future hospitalizations without follow-up.
How should clinicians document for this measure?
Warm handoff + scheduled appointment before ED discharge.
What is the eligible population?
Members with ED visit for MH
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