When a healthcare plan denies a patient coverage for a treatment, procedure or service, doctors and their clinical care staff are in an ideal position to help the patient effectively appeal the denial. A new tip sheet from NAIRO shows doctors and their staff how they can help.
The Academy recently contacted representatives from two Washington D.C.-based organizations to ensure that family physicians continue to be included in utilization review activities.
Employers and insurers decry the recent reform instituting PPOs in Illinois as ‘California Lite’. Plaintiff attorneys claim it will lead to undertreatment and negative consequences for claimants.
Oklahoma City, OK – Governor Mary Fallin signed Senate Bill 878 this week adopting Work Loss Data Institute’s Official Disability Guidelines (ODG) as the standard for evidence-based medicine in determining scope and duration of medical treatment in workers’ compensation effective March 1, 2012. The measure passed unanimously in the Senate, 48-0, and won overwhelming approval, 88-8, in the House of Representatives.