40% of CA Utilization Review Providers Non-Compliant with New Law

I was stunned to read in a recent WorkCompCentral article (subscription required) that only 38 of the 63 firms currently providing workers’ compensation utilization review (UR) services in California are URAC accredited. Per California Senate Bill 1160, the deadline for mandatory accreditation was July 1, 2018. WorkCompCentral’s reported figures on July 9 mean that 40

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Upcoding Crackdown: Federal Efforts Fail to Benefit Private Insurers

For more than a decade, taxpayer-funded health care programs have seen a steady uptick in higher-paying billing codes. Office visits, outpatient services, and emergency room care have all been billed at progressively higher reimbursement codes, raising fees by billions of dollars. Many providers contend the shift is the result of sicker patients coupled with the

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The Road to Optimal Opioid Prescription Length

The Centers for Disease Control and Prevention (CDC) estimates that the total economic burden of prescription opioid misuse in the United States is $78.5 billion a year. Most of that burden is related to workplace costs, such as lost productivity, prolonged time on disability, and increased work disability claim costs. To help combat this crisis, organizations

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