Hospitalized novel coronavirus (COVID-19) patients present unique challenges because their length of stay is often longer and more complex than the typical patient. Their course of illness can also be unpredictable, which makes planning difficult. When a patient is ready to leave the hospital, another set of challenges begins. Even a year into the pandemic, case managers still struggle to find postacute placements and anticipate and identify the needs of these patients.
This week’s Medicare updates include coding and payment information for the Johnson & Johnson COVID-19 vaccine, an OIG report on trends toward more expensive inpatient hospital stays, an MLN article on billing for services when Medicare is a secondary payer, and more!
Q: As of May 1, UnitedHealthcare, the largest health insurance company in the United States, will be switching from using Milliman Care Guidelines (MCG) to InterQual. How will this affect organizations, and what can they do to smooth the transition?