Q: As of May 1, UnitedHealthcare, the largest health insurance company in the United States, will be switching from using Milliman Care Guidelines (MCG) to InterQual. How will this affect organizations, and what can they do to smooth the transition?
Gore Medical Management LLC, a healthcare provider based out of Griffin, Georgia, reported a breach last month that impacted 79,100 individuals, according to the Office for Civil Rights (OCR) breach report.
A new report from the Office of Inspector General (OIG) shows that Medicare billing for high-level inpatient stays increased over a six-year period, sparking concerns by the government about upcoding.
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?
Automating claim transaction saved the healthcare providers, including medical and dental providers, and payers $122 billion in 2019–2020 and moving to fully electronic transactions could yield an additional $16.3 billion in savings, according to the Council for Affordable Quality Healthcare Inc. 2020 Index.
HHS acting Secretary Norris Cochran declared a public health emergency (PHE) for the state of Texas on February 17 as a result of the recent winter storms.
Q: Is it permissible to store paper patient records in a public storage unit? If so, do the storage units need to use specific safeguards to be HIPAA compliant?
