RegQuest™, one of the nation’s premier online regulatory compliance resources focusing on medical management and insurance functions, announces the release of the External Review Regulatory & Market Trends: 2016 Annual Report (ER Trend Report). The report, based on a detailed regulatory survey, academic research and expert interviews, provides a comprehensive overview of external review (ER) regulations, trends and practices.
The National Association of Independent Review Organizations (NAIRO) is hosting its annual conference entitled "Regulatory & Industry Trends Impacting Health Insurance, Appeals & Medical Reviews" is a day-long conference scheduled to take place on October 12, 2016 in Washington, DC.
The new issue brief examines the financial impact of the 2016 reimbursement rate cuts for colonoscopies on practitioners and how this may impact the patient.
RadSite™, a leading accreditation organization promoting quality-based imaging practices, continues to build momentum as UnitedHealthcare and Oxford Health recognize its MIPPA Accreditation Program (MAP) for Advanced Diagnostic Imaging (ADI) accreditation program. Over the past six months, RadSite has received over a dozen recognitions from private payers and radiology benefit management organizations.
May 26, 2016 -- RadSite™, a leading accreditation organization promoting quality-based imaging practices, is seeking nominations to serve on its Accreditation and Standards Committees and support the organization’s quality benchmarking activities for diagnostic imaging. “RadSite’s quality-benchmarking activities incorporate key process and outcome measures, with the ultimate mission of improving image quality and reducing patient radiation dose,” reports Eliot Siegel, MD, RadSite’s chief technology officer. “The additional peer review by qualified third-party representatives will further enhance RadSite’s standards, accreditation process, and research activities,” notes Dr. Siegel, who also serves on RadSite’s Advisory Board and is the chair of RadSite’s Accreditation Committee.
AliCare Medical Management (AMM) (www.alicaremed.com), a leading provider of high-quality, clinically-based care management programs and a member of the Amalgamated Family of Companies, announces its ability to support health plans, consumers and providers through a seamless appeals system that covers clinical and administrative appeals, including denial of services related to mental health and substance use disorder (MH/SUD) treatments. Reviewing behavioral health coverage determinations are a critical part of the medical management system due to new federal and state parity laws that have been adopted in recent years.
RegQuest™, one of the nation’s premier online regulatory compliance resources focusing on medical management and insurance functions, is pleased to announce a webinar specifically centered on external review regulations, practices and programs. This webinar, titled External Review: Navigating Nuances in Regulatory and Market Trends, will take place on May 24, 2016 at 12:00 p.m. EST.
RadSite™, a leading accreditation organization promoting quality-based imaging practices, continues to build momentum as more payers recognize its Advanced Diagnostic Imaging (ADI) accreditation program. In addition to the U.S. Centers for Medicare and Medicaid Services (CMS), an expanding number of health plans, insurers and radiology benefit management (RBM) organizations are recognizing RadSite’s MIPPA Accreditation Program (MAP).
RegQuest™, one of the nation’s premier online regulatory compliance resources focusing on medical management and insurance functions, is pleased to announce a webinar specifically centered on the status of mental health parity laws and consider how best to achieve true equity in care for those individuals suffering from mental health or substance use disorders. This webinar will take place on April 28, 2016 at 12:00 p.m. EST.
RegQuest™, one of the nation’s premier online regulatory compliance resources focusing on medical management and insurance functions, is pleased to announce the first in a series of webinars focusing on the evolution of utilization management (UM) programs and related medical management functions over the past three decades with a detailed overview of how UM programs are regulated and operationalized today.