As of May 1, UnitedHealthcare, the largest health insurance company in the United States, will be switching from using Milliman Care Guidelines (MCG) toInterQual.
Though the adoption of outpatient CDI has been growing steadily over the years, it’s not always easy to prove the return on investment for such efforts.
Q: When two conditions are both present on admission, both meet the definition to be the principal diagnosis, and are “equally treated,” my understanding is that the condition does not have to be "equally treated" in the sense of duration/frequency. Is this correct?
Ellen, a case manager, works more than 40 hours every week on-site at her hospital. This has been her schedule since the novel coronavirus (COVID-19) pandemic restrictions were put in place. She is a single mother and decides, despite the virus risk, to work as many hours as possible.
This week's note from the instructor looks as how to use E/M risk assessments as part of a strategy to measure the level of compliance with laws, regulations, and internal policies and procedures.
