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.