Healthcare Insights

Sepsis Upcoding is Costing Health Plans a Fortune

Sepsis is one of the most frequently diagnosed DRGs. It’s also one of the most expensive. The condition has been a hotly contested issue among providers, payors, and regulatory agencies for decades, and remains a continued source of disagreement today.

Top 5 Ways Smaller Health Plans Can Realize Big Savings

In today’s increasingly complex healthcare landscape, small- to medium-sized health plans may lack the scope and depth of clinical resources to fully establish a proven payment integrity solution.

Cardiologist Michael J. Menen, MD, Joins MedReview as Chief Medical Officer

MedReview, Inc., a leading provider of payment integrity, utilization management and quality surveillance services, is pleased to welcome Michael J. Menen, MD, FACC, as its new chief medical officer (CMO).

MedReview Achieves HITRUST® Authorized External Assessor Designation

MedReview, Inc., a leading provider of payment integrity, utilization management and quality surveillance services, today announced its designation as a HITRUST Authorized External Assessor by HITRUST.

Americans paying billions for drugs that don’t work

Created in 1992 in response to the AIDs crisis, the Food and Drug Administration (FDA) accelerated approval pathway is intended for drugs that address unmet medical needs.

AHIP 2022 is history. But its lessons are driving the future of healthcare.

In its first live conference since 2019, AHIP’s flagship event brought together some of the brightest minds in the industry to share insights and innovations that have the power to reshape the future of healthcare.