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Author Question: How does utilization management within the hospital setting differ from utilization management in ... (Read 37 times)

Engineer

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on: Jul 12, 2018
How does utilization management within the hospital setting differ from utilization management in the ambulatory care setting?

Question 2

The main factor usually considered in choosing a coding system for ambulatory care is ___________________ _________________.
 a. what is easiest for the physicians
  b. what is required by third-party payers
  c. what is easiest for the coders
  d. what is required by the state health department


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sultansheikh

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Reply #1 on: Jul 12, 2018
Answer to Question 1

In the hospital setting, utilization management focuses on whether the patient requires hospitalization. In the ambulatory care setting, utilization management focuses on the necessity of a service such as referral to a specialist or the use of an expensive procedure.

Answer to Question 2

b. what is required by third-party payers


Engineer

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Reply 2 on: Jul 12, 2018
Great answer, keep it coming :)

vickybb89

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Reply 3 on: Yesterday
Thanks for the timely response, appreciate it

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