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.
CMS walked back some major policy changes and cemented others in the 2022 Inpatient Prospective Payment System (IPPS) final rule. Brush up on the latest changes and ensure your hospital is ready to comply by October 1.
Inadequate documentation is a common pain point for coding and CDI efforts. Learn how one organization created a documentation education resource for their physicians.
Understanding how condition codes 44 and W2 affect reimbursement and workflows in various scenarios is key to knowing when and how to use them most effectively. Apply expert advice to create appropriate processes at your organization.
Hospital observation service codes are to be reported only for evaluation and management (E/M) services provided to patients who are admitted to observation. Review reporting and documentation guidelines to ensure accurate coding for these services.
