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.
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.
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 a notice about how CMS is planning to handle payments for 340B drugs for the rest of the year, an update to the ambulance inflation factor for 2023, the notice of the new interest rate for Medicare overpayments and underpayments, and more!
