United Healthcare’s Medicare Advantage and the Two-Midnight Rule

Published: Wed, 11/29/23

Link to all things medical coding & billing

United Healthcare’s Medicare Advantage and the Two-Midnight Rule

Well, I suppose I have given you enough of a break from my writing about Medicare Advantage (MA) plans and the Two-Midnight Rule. Last week, United HealthCare (UHC) released its coverage summary for hospital care for patients with UHC Medicare Advantage.

Beware: Recent Changes to MDS Could Cause Audits

Recent changes to the minimum data set (MDS) assessment and recent audit activity targeting skilled nursing facilities (SNFs) appear to be an emerging issue. As a reminder, the MDS assessment is a standardized assessment used in SNFs and some swing-bed facilities to capture administrative and...

Feds propose rule changes for No Surprises Act

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Staying Current with Medical Necessity

A new quarter began on Oct. 1, an event that usually brings updates to National Coverage Determinations (NCDs). The coding updates included for Oct. 1 are specified in Change Request (CR) 13166, which is a maintenance update. This document is mentioned in the MLN Connects published Sept. 28.

Asking clinicians to enhance their medical coding skills, another necessary task

Clinicians today are confronted with an increasing administrative burden alongside their patient care responsibilities, and a critical aspect of this burden is medical coding. This skill is crucial as it serves multiple purposes, including meeting billing standards affecting reimbursement, complying with quality...

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