The variety of sources for commercial insurance requirements can present challenges to the utilization review (UR) specialist, as UR rules for every patient could differ depending on his or her insurance and that insurer’s policies. Apply these lessons to help UR manage commercial insurance requirements.
Jessie, a nurse case manager, feels healthcare has changed since the beginning of the pandemic. She believes that the greatest change comes from the recent initiation of new healthcare coverage plans, primarily Medicaid managed care and Medicare Advantage.
Directors are searching for solutions to the healthcare staffing shortage. Could one of them involve changing your leadership style to boost outcome achievement?
In early June, Congress released a bipartisan draft bill called the American Data Privacy and Protection Act. The goal of this bill is to create a regulation that organizations in any industry would need to accord with compliance. On the surface, this sounds great, but in reality, it is unrealistic.
This week’s Medicare updates include new items added to the OIG Work Plan, an extension for certain payment rate adjustments for low volume and Medicare dependent hospitals, and more!
In August, the Office for Civil Rights (OCR) announced a settlement with New England Dermatology P.C., known as New England Dermatology and Laser Center, over the improper disposal of PHI, which is a potential HIPAA Privacy Rule violation.
