UnitedHealthcare recently transitioned its utilization management approach for all of its health plans from Milliman Care Guidelines to InterQual criteria. Learn how this change could have far-reaching impact on hospitals.
This week's note from the instructor discusses CMS' proposal in the CY 2022 OPPS proposed rule to reverse course on CY 2021 changes to the inpatient-only list and the ambulatory surgical center covered procedures list.
HHS recently issued its Summer 2021 OCR Cybersecurity Newsletter, covering the topic of controlling access to ePHI. HHS officials cited a Verizon 2021 Data Breach Investigations report that found 61% of analyzed data breaches in the healthcare sector were perpetrated by external threat actors and 39% were carried out by insiders.
To select the most specific CPT codes for prenatal care, physician coders must have a solid understanding of complex guidelines for reporting pregnancy-related office visits. Lori-Lynne A. Webb, CPC, CCS-P, CCP, CHDA, COBGC, unpacks services included in the global obstetric package and CPT coding for routine prenatal care.
This week’s Medicare updates include an announcement on expanded payments for at-home COVID-19 vaccinations, dates for implementation of the Prior Authorization Model for Repetitive, Scheduled Non-Emergent Ambulance Transports nationwide, an OIG review of phlebotomy travel allowances, and more!