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Displaying records 1 to 20 out of 2904 results for "Utilization Review".
( Page 1 of 146 )
SORT RESULTS BY: RELEVANCY | PUBLICATION DATE
The Hospital Guide to Contemporary Utilization Review is a comprehensive resource designed to ide
SEPTEMBER 15, 2015
The Hospital Guide to Contemporary Utilization Review is a comprehensive resource design
JANUARY 12, 2016
The Hospital Guide to Contemporary Utilization Review is a comprehensive resource designed to ide
NOVEMBER 24, 2015
The Hospital Guide to Contemporary Utilization Review is a comprehensive resource design
NOVEMBER 17, 2015
The Hospital Guide to Contemporary Utilization Review is a comprehensive resource design
JANUARY 19, 2016
Medicare Boot Camp®—Utilization Review Version  
Q: How many people should be involved in reviewing a medical record?
The public use file is a file that is used by policymakers and researchers that review the fee-fo
The role of the utilization review (UR) committee has changed as facilities move to reporti
Medicare Boot Camp®—Utilization Review Version  
Medicare Boot Camp®—Utilization Review Version
Medicare Boot Camp®—Utilization Review Version
Medicare Boot Camp®—Utilization Review Version
  With the release of therapy utilization data, SNFs must prioritize individualized care
In CMS’ targeted probe-and-educate review, MACs will send ADRs to agencies that struggled
Medicare Boot Camp—Utilization Review Version is an i
Does your organization have a utilization management ­committee? Did y
NOVEMBER 1, 2013
No. I recommend you continue with utilizing non-clinicians in intake. You need to provide the rig
There is one phenomenon in the PPS that has caught the attention of medical reviewers.
Q: Our MAC is reviewing our pulmonary rehabilitation and physician therapy (PT) and occ
OIG adds review of Part A claims to the 2014 LTC Work Plan
AUGUST 1, 2014
  The medical review department chose to conduct a postpayment review...now what?
MARCH 30, 2018
  Medicare Review: Ways to evaluate claims
OCTOBER 2, 2015
In the fall of 2015, the ACGME Board of Directors began a complete review of the Common Program R
APRIL 5, 2018
Medicare Compliance Review of Saint Luke's Hospital of Chesterfield for 2011 and 2012
Medicare Compliance Review of Saint Luke's Hospital of Chesterfield for 2011 and 2012
By A.J. Plunkett Review and update your all-hazards risk assessme
MARCH 7, 2019
Who can conduct the (medication) review? The regulations require a drug
  Unannounced audit! What do you need to review first?
DECEMBER 14, 2016
  How to make the most of your Medicare Review
AUGUST 8, 2017
  What to do when you are under medical review
OCTOBER 13, 2017
  Billers instructed to review CMS updates to Medicare policy manuals
MARCH 23, 2018
  Providers encouraged to review eligibility requirements for expanded dispute resolution proce
  Review your performance data before July 1!
  Seven tips for reviewing and responding to PEPPER reports
SEPTEMBER 14, 2018
by Josh Poltilove and A.J. Plunkett Review emergency preparedness policies and pro
 This week’s updates include a new ACO dialysis model, new Medicare utilization and pa
What should the (medication) review include? The language in the regula
We are looking for reviewers for our 2017 book projects. If you’re interested in participa
JANUARY 12, 2017
How does an agency keep the drug review up to date? The regulations req
We are still looking for participants for our Nursing Book Review Group! Now is your chance to j
APRIL 21, 2016
  Manual medical reviews for therapy shift to a targeted approach, but questions remain
APRIL 15, 2016
  CMS is hosting a live webcast for SNFs: How review and correct reports fit into quality repor
  The Skilled Nursing Facility Quality Reporting Program Review and Correct reports are availab
  SNF provider preview reports now available, review before June 30
While an all-hazards risk assessment is required for the annual review of your emergency prepared
AUGUST 10, 2017
Which medications are subject to review?   A clinician must
Therapy visits have a direct impact on the first (grouping step) and fourth (services utilization
Therapy visits have a direct impact on the first (grouping step) and fourth (services utilization
Nursing peer review committees operating in good faith are protected from incurring civil liabili
APRIL 17, 2015
What documentation is necessary for a medication review? The regulation
The Centers for Medicare & Medicaid Services (CMS) has announced that the pre-claim review de
Performance review time is never easy. Managers have the uncomfortable task of assessing their te
FEBRUARY 18, 2016
  Patients are turning to online review websites such as Yelp, Healthgrades, and R
NOVEMBER 20, 2014
Q: Is there an industry standard metric goal for CDI specialist reviews of Medicare cases?
The period for physicians to review and dispute financial information reported under CMS&r
APRIL 9, 2015
In an analysis of more than 1.7 million reviews on Yelp, ProPublica found that some phys
DECEMBER 16, 2015
JUSTCODING
During HCPro’s webcast review-seven-challenge
FEBRUARY 20, 2015
As of April 1, 2017, the Pre-Claim Review demonstration will be paused for at least 30 days in Il
A Q&A around drug regimen review items was provided by CMS.   CMS’
Following a Clinical Learning Environment Review (CLER) site visit, a report will arrive in your
MARCH 23, 2018
Documentation will be important to support supply utilization and payment. Claims
Residents are a little-utilized but critical link in the documentation chain that drives
JULY 14, 2017
Residents are a little-utilized but critical link in the documentation chain that drives hospital
JULY 7, 2017
Last week we launched our patient safety and quality book review group and we thank everyone who
AUGUST 12, 2015
Last week we invited you to join our nursing book review group and we thank everyone who has exp
JULY 30, 2015
The following is an excerpt from review-second
SEPTEMBER 21, 2017
Physicians have until May 15 to review and file any necessary disputes regarding their financial
APRIL 28, 2016
During the second review, program directors, faculty, and coordinators will thoroughly review the
OCTOBER 25, 2013
When we previously discussed post-interview reviews of letters of recommendation (LOR) and perso
APRIL 28, 2017
If you’re looking for a better way to track peer review cases, mark Tuesday, June 10 on yo
Dear readers, HCPro is researching a book that would include peer review benchmar
MARCH 3, 2016
A recent poll of parents found that a majority of them are concerned that online reviews of physi
MARCH 24, 2016
To date, Clinical Learning Environment Review (CLER) visits are scheduled to occur every 18 to 2
OCTOBER 27, 2017
SEPTEMBER 24, 2014
JUSTCODING
MARCH 9, 2017
Understanding OPPE, part 1: Peer review by any other name
DECEMBER 1, 2014
CMS will not conduct post-payment patient status reviews for admis
The policies and administrative practices of the agency are reviewed to determine the extent to w
by Josh Poltilove Agencies seeking to pass CMS’ Review Choice Demonstratio
In FY 2014, the OIG is setting out to review some aspects of billing and payments that were not i
Does your facility perform outpatient clinical documentation improvement (CDI) reviews?
SEPTEMBER 3, 2014
JUSTCODING
Does your facility perform outpatient clinical documentation improvement (CDI) reviews?
SEPTEMBER 10, 2014
JUSTCODING
On June 7, the OIG posted a report stating it reviewed CMS’ administration of the Pioneer A
Palmetto GBA announced it will conduct pre-payment, service-specific, probe medical review on Hos
I have some questions regarding the CMS Instruction for Medical Review on Home Health Ce
During the recent webcast, review-seven-challenges-for-tod
APRIL 30, 2015
By utilizing the information documented in the record, coders can report the BMI from a dietitian
A pharmacist must review all medication orders prior to the medication being dispensed exc
APRIL 22, 2014
The New Jersey Attorney General's Office has advised South Jersey prosecutors to review all auto
An automated Recovery Auditor review of discharge status codes identified improper payment
MAY 6, 2015
JUSTCODING
Can you give a review of how the proposed CoPs might change things? The agency mu
First step, ask your biller for the remarks that are submitted by the reviewer at the MAC. On the
The quality measure “drug regimen review conducted with follow-up for identified issues&rdq
Regardless of the clinical background of those responsible for reviewing documentation, it can be
Pre-claim review pilot goes live in Illinois—2 days late
  Most improper payments for diagnostic nasal endoscopies reviewed during a Compre
SEPTEMBER 30, 2015
JUSTCODING
Of the 394 sentinel events reviewed by The Joint Commission in the first half of 2014, unintended
SEPTEMBER 30, 2014
Join us at 1 p.m. (Eastern) Thursday, November 13, to review the big changes coming for modifier
Join us at 1 p.m. (Eastern) Thursday, November 13, to review the big changes coming for modifier
Two more studies reviewing resident work hour restrictions land squarely in the middle of the lon
MARCH 11, 2015
Providers may want to review claims containing HCPCS code C2623 (catheter, transluminal an
This therapy M item should be reviewed once all initial orders have been received by the agency f
In the fall of 2015, the ACGME Board of Directors began a complete review of the Common Program
APRIL 5, 2018
OCTOBER 7, 2015
JUSTCODING
In many states, the incident report can be reviewed by the plaintiff's attorney. Therefore, it is
SEPTEMBER 3, 2015
Find out what's happening in GME by reviewing a few recent residency headlines from across the co
AUGUST 25, 2017
In many states, the incident report can be reviewed by the plaintiff's attorney. Therefore, it i
FEBRUARY 14, 2019
MARCH 18, 2015
JUSTCODING
MARCH 11, 2015
JUSTCODING
MARCH 4, 2015
JUSTCODING
FEBRUARY 25, 2015
JUSTCODING
by Josh Poltilove CMS’ supplemental medical review contractor (SMRC) has beg
A review of more than 2,000 neurosurgical cases published in the
NOVEMBER 30, 2017
A review of more than 2,000 neurosurgical cases published in the
NOVEMBER 28, 2017
OIG posts Medicare Compliance Review of Saint Luke's Hospital On Augus
  As a nurse manager, how often do you review the duties and responsibilities laid o
JUNE 24, 2015
Q: Is there guidance on reviewing a record, such as an operative note, that has not been sig
NOVEMBER 4, 2015
JUSTCODING
AUGUST 5, 2015
JUSTCODING
A Recovery Auditor review of claims from September 25, 2012, to August 30, 2013, found pro
SEPTEMBER 16, 2015
JUSTCODING
In the fall of 2015, the ACGME Board of Directors began a complete review of the Common Program
JANUARY 13, 2017
Managers should not assume that they can review every guideline, every item in Coding Clinic,
Announced in 2012, the ACGME’s Clinical Learning Environment Review (CLER) was established
JULY 21, 2017
After CMS review, The Joint Commission has finally prepublished revisions to the Emergency Manage
Review agency policies and procedures around infection control and update them. D
Dear readers, Have you reviewed the ACGME’s
MARCH 9, 2018
By Jay Kumar A new review of 144 studies found that healthcare-
SEPTEMBER 27, 2018
By Jay Kumar A new review of 144 studies found that healthcare-
SEPTEMBER 25, 2018
If you haven’t seen the OIG report “Medicare Compliance Review of University of Cinc
At the close of fiscal year 2013, nearly 5,000 claims denials remained pending review at the Departm
At ACDIS we’re seeing more and more departments expand their medical record reviews to focu
MARCH 25, 2015
JUSTCODING
Q: Is there guidance on reviewing a record, such as an operative (OP) note, that has
Reviewed by Jennifer Kennedy, MA, BSN, RN, CHC Hospice is a growing and
Last summer, we asked you to join our Nursing Book Review Group and the response was overwhelming
MARCH 10, 2016
Last summer, we asked you to join our Nursing Book Review Group and the response was overwhelmin
MARCH 17, 2016
Join us August 18 at 1:00 p.m. (Eastern) for this 90-minute webcast for a comprehensive review of
Reviewed by Mary Ellen Conway, RN, BSN A home health agency depends on i
You should review the final CoPs and the draft interpretive guidelines. Sections
Q: My agency has been reviewing the proposed Conditions of Participation (CoP). We are looki
In the fall of 2015, the ACGME Board of Directors began a complete review of the Common Program R
JANUARY 13, 2017
Medicare’s Pre-Claim Review Demonstration (PCR) rollout has been anything but smooth, with
JUNE 17, 2015
JUSTCODING
These Occupational Health and Safety Forms provide you with all of the updates for your OSHA Health and Safety Compliance Manual.
DECEMBER 17, 2008
Many CDI programs understand the need to expand their reviews beyond CC/MCC capture rates. But wh
OCTOBER 29, 2014
JUSTCODING
In a paper that will be published in a future issue of American Economic Review, Ma
MARCH 20, 2015
Hospitals under fire to review and revamp their policies and procedures in the wake of dangers f
DECEMBER 22, 2016
Agencies should review and update their employment and disciplinary policies now that the
Terms of use synopsis
SEPTEMBER 4, 2008
The administrator, clinical manager, and any other key personnel should begin reviewing the State
Health Professional Shortage Area (HPSA) Post-payment Review Process
Q: I am looking for help on reviewing a neonatal intensive-care unit (NICU) death chart for
Many CDI programs are shifting their focus to include some sort of quality review. One of those i
The government will have to comply with its congressionally mandated deadlines for reviewing clai
CMS review has prompted waves of changes. Even more changes to The Joint Commission&rsq
APRIL 20, 2017
A: As part of a monthly or quarterly quality assurance review, agencies should closely monitor co