TN0708 IMMUNOGLOBULIN THERAPY � IVIG
PREAUTH		CLAIMS
MIN. CLINICAL SYMPTOMS	MIN. REQUIRED	CRITERIA	DETAILS	% breakup amount - claims	POINTS AWARDED	SPECIAL MENTION
		TOTAL BED DAYS		20
		INVESTIGATIONS	GENERAL WORK UP	30
			WORK UP TO FIND THE CAUSE		mandatory
			PHOTO OF THE PATIENT RECIEVING IMMUNOGLOBULIN THERAPY � COMPLETE BILLS AND DETAILS OF DRUGS		mandatory
		TREATMENT	IV IG TREATMENT	50	mandatory	PAYMENT ACCORDING TO DOSE ADMINISTERED - ( SUBJECT TO LIMIT )