Utilization review

Hi all,

Not sure how many of you are involved in utilization review, but I have a couple quick questions for anyone in the group who is able to chime in.

1. Would you be interested in a utilization review handbook with practical, everyday guidance? Why or why not?

2. What utilization review topics are of most interest to you?

Thanks in advance!

On another note, how many of you will I be seeing at AHIMA next week?

Best,
Jaclyn Fitzgerald
Editor, HCPro
jfitzgerald@hcpro.com

Comments

  • edited May 2016
    1. Would you be interested in a utilization review handbook with practical, everyday guidance? YES Why or why not? Would help to understand the role medical necessity plays in the codes we submit to billing as in HIM and why some cases are denied payment even though we have a UR review when the patient was in house.

    2. What utilization review topics are of most interest to you? How the decisions of UR affect coding and billing


    DWT

    Donna Walker-Thomas, MBA, RHIA, CPC, CMA/Director of Coding/The Miriam Hospital
    Phone: 401-793-3202/Fax: 401-793-3750

    Please contact Maryann Heywood, Executive Secretary @401-793-2265 if scheduling a meeting

    Paint the picture of the patient properly with words, so the coder can paint the same picture with codes – Dr. Gold

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