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.
As the country sees a resurgence of COVID-19 thanks to the delta variant, hospitals are seeing an increase not only in their immediate census numbers, but also in the number of readmissions.
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!
Review proposed updates to the CPT set for 2022, including new codes for chronic care management, laser interstitial thermal therapy, spinal anesthesia, and more.
Audits are ramping up across the country, creating additional headaches for many healthcare organizations as they simultaneously struggle with the delta variant of COVID-19.
