The medical necessity review plays a crucial role in maintaining the quality, efficiency, and cost-effectiveness of healthcare delivery. In this comprehensive guide, we will delve into the intricate process of medical necessity reviews, highlighting their significance, key considerations, and how they influence patient care and reimbursement.
Nowhere is balance more evident than in the domain of case management, where the thorough examination of patient cases serves as the bedrock of informed healthcare decisions. Unlocking the power of healthcare case management requires optimizing both the efficiency of the process and the effectiveness of patient outcomes.
The challenges faced by healthcare professionals have become increasingly complex, demanding innovative solutions that go beyond traditional approaches. One such solution gaining traction is physician peer-to-peer collaboration—a concept that holds the potential to revolutionize healthcare delivery and drive advancements across the industry.
Prior Authorization AI and the Future - The process of prior authorization can be time-consuming and complicated for healthcare providers.
Psychiatrist shortage by the numbers: The current workforce of about 45,580 psychiatrists must increase by 2,800 to meet today’s demands for psychiatric care. This works out to a 6.4 percent shortage. By 2025, that shortage could be as high as 6,090 psychiatrists, or 12 percent, according to the U.S. Department of Health and Human Services.
There are numerous health-related challenges facing rural areas of the U.S., including geographic isolation, an aging population, and a shortage of providers and hospitals, especially as rural hospitals close at unprecedented rates.
CMS updated its Opioid Prescribing Mapping Tool to give users a more in-depth look at opioid prescribing rates across the U.S., the agency announced Feb. 22.
Among patients ages 65 and older, the rate of opioid-related hospitalizations jumped 34 percent between 2010 and 2015, according to statistical brief from the Agency for Healthcare Research and Quality.
West Virginia has the highest rate of fatal opioid overdoses among U.S. states, with 49.6 per 100,000 individuals, according to data from the Kaiser Family Foundation.
Chronic pain patients don't fare much better taking opioids to manage their pain than they do by taking placebos, a study published recently in the Journal of the American Medical Association found.