New Study Reveals Need for Increased Transparency of Medical Necessity Determinations
The Utilization Management Regulatory & Market Trends: 2016 Annual Report released by RegQuest illuminates the complex web of rules, policies and
practices that affect how medical care is actually paid for and who is impacted
in the process. Importantly, the report highlights how patients and attending
providers appeal adverse benefit determinations. As the first update on this
topic in over a decade, the report is a must-read for health care
professionals, compliance staff, benefit administrators, case managers and
other stakeholders who require a comprehensive understanding of medial
management regulations, such as utilization management. For a complimentary
report preview and more information on RegQuest, please click here. CMSA members
are eligible for discounted pricing.