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.
Anna, a case manager who practices in a pulmonologist’s office, manages adult high-risk asthmatic patient care. The office serves more than 2,000 patients, which Anna learns is the upper range of average. She recently learned that the American Association for Physician Leadership believes that a physician’s office can successfully handle a volume of 3,000 patients.
Review proposed updates to the CPT set for 2022, including new codes for chronic care management, laser interstitial thermal therapy, spinal anesthesia, and more.
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.
