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Prior Authorization Is Changing

EvidenceCare

Service Categories Affected by PA Advanced imaging (MRI, CT, PET) Elective surgeries (orthopedic and bariatric) Behavioral health (IOP, residential) Specialty biologics and infusions Cardiac diagnostics/tests DME (wheelchairs, CPAP machines) Inpatient admission from ED or observation What’s changing? Kennedy, Jr.

Insurance 147
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Primary care news round-up (10th July – 16th July 2025)

Practice Index

New evidence for care continuity Continuity of care with GPs is linked to reduced mortality and admissions to hospital, according to a new study. The post Primary care news round-up (10th July – 16th July 2025) appeared first on GP Practice Management Blog. in General Practice in 2024-25, including £13.6m He is due to meet them today.

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Primary care news round-up (5th to 11th June 2025)

Practice Index

New centres to aid NHS next winter The NHS in England is to open dozens of new centres next winter to try to avoid unnecessary hospital admissions. The post Primary care news round-up (5th to 11th June 2025) appeared first on GP Practice Management Blog.

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Navigating Medicare Advantage: Strategies for Hospitals to Tackle Growing Challenges

EvidenceCare

These include updates to the Star Ratings system, RADV (Risk Adjustment Data Validation) audits, the upcoming 2025 Final Rule containing the final rate announcements, and adjustments to prior authorization requirements. Physicians must learn to be specific and capture the “why” for patient admissions and the risk of discharge.

Hospital 130
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Between the Charts: CMIO Newsletter for Prescribers - Issue 19 Now Available

Connect Care Bytes Blog

Newsletter: Between the Charts - June 2025 Manual: Between the Charts Archive (news.connect-care.ca) Feedback: CMIO-Manual@ahs.ca If you have any feedback on this issue or have a suggestion for content you'd like included in a future issue, please send us an email. Note there will not be a July issue, so the next will be in August.

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What do the Neighbourhood Health Guidelines mean for Practice Managers?

Practice Index

The publication of the Neighbourhood Health Guidelines for 2025/26 has once again left general practice in the dark. While the document sets out a vision for integrated, community-focused care, it provides little in the way of clear guidance for GP practices, leaving them uncertain about how they fit into the evolving system.

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Connect Care Scheduled Downtime and Spring Upgrade - Thursday March 13, 2025, 00:30-04:30

Connect Care Bytes Blog

The next scheduled update will occur during downtime on Thursday, March 13, 2025, between 00:30 and 04:30. This downtime window is specifically for the Spring 2025 Upgrade, with changes to most Connect Care applications. What you need to know The Connect Care clinical information system needs periodic maintenance.