April 2022

doctor holding stethoscope

Case Study: Alcohol Withdrawal Inpatient Denial Overturned Based on Care Required

Case Study / By

Alcohol withdrawal and a positive COVID infection resulted in an inpatient hospital stay for one patient; however, the insurance company denied the short stay. A detailed peer-to-peer discussion of this case with the insurance company overturned the denial based on the acute symptoms and the medical and supportive care required. CLINICAL SUMMARY: Alcohol Withdrawal A […]

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Justice Department files lawsuit against UHC to stop Change Healthcare acquisition

Justice Department Files Lawsuit Against UnitedHealth to Stop Change Healthcare Acquisition

Blog, Utilization Review / By

The United States Department of Justice filed an antitrust lawsuit earlier this year aiming to stop UnitedHealth Group from acquiring Change Healthcare.1 Hospital CFOs and utilization review managers have much to watch in this case related to how it could not only impact competition in the markets but how it could impact the guidelines used

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