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Explore Our Clinical Webinars for Payer Organizations

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AllMed offers an extensive library of educational resources that help our clients stay abreast of emerging clinical procedures and therapies to support improved clinical decision making.


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Marketing Page Prenatal Screening and Diagnostic Testing: Which Tests Are Medically Necessary?
The number of prenatal screening test options has increased in recent years. Non-invasive tests, such as ultrasonongraphy and certain blood tests, are part of routine prenatal care and can help determine whether more invasive tests are needed. Many tests, however, are often offered to all pregnant women. It is important to weigh the benefits and risks associated with these tests, which are not always without risk, particularly for the fetus.
Marketing Page Diabetes Management: When are Blood Glucose Monitoring Systems Medically Necessary?
Blood glucose monitoring allows patients with diabetes to understand patterns of blood glucose changes so that diet, exercise, and medication dosing can be adjusted as needed. There are numerous blood glucose monitoring systems, from basic models to those with multiple features and options. The cost of blood glucose meters and test strips varies, as well as health plan coverage for these products.
Marketing Page Treating Clinical Obesity: When is Bariatric Surgery or Bariatric Surgery Revision Medically Necessary?
The incidence of obesity continues to increase in the United States, along with other related health problems, placing an enormous strain on the healthcare system. Patients who do not lose weight with traditional weight management approaches may turn to bariatric surgery procedures, such as gastric bypass and laparoscopic adjustable gastric banding. Although bariatric surgery can effectively treat obesity by helping patients achieve substantial, sustained weight loss, many health plans cover these procedures only when individuals meet very specific criteria and have well-documented failure of medical management.
Marketing Page Treating Chronic Sinusitis: When is Balloon Sinuplasty Medically Necessary?
Despite advances in instrumentation and technology, the management of chronic sinusitis and related conditions remains challenging for both physicians and patients, especially as treatment guidelines and recommendations continue to evolve. Although balloon sinuplasty has been shown to be safe and effective in a number of studies, its use has not yet gained widespread acceptance as a standard of care for the treatment of patients with chronic sinusitis.
Marketing Page Indications for Lumbar Fusion: Establishing Standards for Medical Necessity
The annual number of spinal fusion operations performed in the United States has increased by more than 80% in the past decade. Off-label use of spinal procedures has also increased. Although a number of conditions of the spine benefit from lumbar fusion, some off-label uses are associated with inconsistent outcomes and significant potential risks and complications.
Marketing Page Treating Gastroesophageal Reflux Disease (GERD): When Is the LINX Reflux Management System Medically Necessary?
The LINX Reflux Management System was approved in 2012 as a minimally invasive alternative to Nissen fundoplication, which has long been the surgical gold standard for patients with gastroesophageal reflux disease (GERD) that has not been responsive to medical therapy. Many health plans, however, still consider the LINX device experimental and investigational for the management of GERD. This may change, however, as long-term safety and efficacy data on the device have recently become available.
Marketing Page Webinar - Influenza Treatment Guidelines Update for 2015-2016: When are Antiviral Agents Medically Necessary?
While flu seasons are unpredictable, the Centers for Disease Control and Prevention continues to recommend annual vaccination as the best tool for preventing influenza, as well as timely use of antiviral medications to treat influenza in select patients. In some cases, rapid diagnostic testing may be useful in selecting appropriate treatments. While antiviral drugs can help reduce the duration and severity of flu symptoms, the decision to use them must be based on individual evaluations of risk and benefit.
Marketing Page Webinar - Determining Prognosis and Planning Treatment for Patients with Cancer: When are Oncotype DX Assays Medically Necessary?
A recent study found that Oncotype DX results changed the oncologist’s choice of treatment in about one third of cases. In breast cancer patients, the most common change in treatment involved a shift away from chemotherapy and hormone therapy, to hormone therapy alone. When used in conjunction with consensus guidelines and risk assessments, Oncotype DX and other gene profiling assays can help to determine appropriate treatment options, as well as overall survival, recurrence probability, and responsiveness to chemotherapy.
Marketing Page Cervical Disc Replacement: When is the Mobi-C Cervical Disc Medically Necessary?
Cervical disc replacement has become an increasingly viable alternative to spinal fusion for select patients, as longer-term data and improved technology continue to emerge. The Mobi-C Cervical Disc is currently the only cervical intervertebral disc prosthesis that has been approved by the U.S. Food and Drug Administration to treat more than one level of the cervical spine.
Marketing Page Webinar - Treating Cataracts: When is Surgery Medically Necessary?
The current cataract procedure of choice involves removing the natural lens of the eye and implanting an IOL. The type of IOL used is dependent on physician recommendation and the visual needs of each individual patient. While monofocal IOLs are considered the standard and meet the basic functional needs of patients who undergo cataract removal, technological advancements have led to the development of other types of IOLs.
Marketing Page Webinar - Blepharoplasty: When Is Eyelid Surgery Medically Necessary?
Blepharoplasty, or eyelid surgery, is commonly performed for cosmetic reasons to improve appearance. However, in some cases, the surgery may be necessary to remove overhanging skin folds to improve the function of the upper eyelid, as well as to improve vision. Although definitions for medically necessary blepharoplasty can vary by health plan, all patients must meet specific documentation requirements, with many plans requiring visual field testing.
Marketing Page Webinar - Pediatric Physical, Occupational, and Speech Therapy: When Are These Rehabilitation Services Medically Necessary?
Children who need rehabilitation services often have complicated healthcare needs that put them at risk for chronic physical, developmental, and behavioral conditions. The concept of rehabilitative therapy includes recovery or improvement in function and, when possible, restoration to a previous level of health and well-being. Therefore, evaluation, re-evaluation, and assessment must be clearly documented to rationalize the initation of treatment or to justify continued treatment.
Marketing Page Webinar - Wearable Cardioverter-Defibrillators: When Are They Medically Necessary?
As many as 20% of patients in the United States who receive an implantable cardioverter-defibrillator (ICD) do not meet current guidelines for patient selection, which increases risk of mortality and serious complications. While WCDs are designed to perform the same functions as ICDs and are noninvasive, careful patient selection remains critical in order to avoid potential complications, as well as to improve the efficacy of these devices.
Marketing Page Webinar - Managing and Treating Hepatitis C: When Is Olysio (Simeprevir) Medically Necessary?
The U.S. Food and Drug Administration (FDA) recently expanded the indications for simeprevir so that it can be used as part of a new direct-acting treatment combination. As the treatment of HCV continues to evolve, new and more complex protocols present additional challenges in providing optimal care while meeting the unique needs of individual patients.
Marketing Page Webinar - Stereotactic Body Radiation Therapy (SBRT): When Is SBRT Medically Necessary?
Advances in stereotactic radiation techniques have resulted in safer delivery of high doses of radiation to extracranial sites with reduced toxicity and improved outcomes. The clinical applications of SBRT, however, currently remain limited. Some clinicians may attempt to justify the use of SBRT for certain types of cancers based on results from small studies that lack sufficient data.
Marketing Page Webinar - Influenza Treatment Guidelines Update: When Are Antiviral Agents Medically Necessary?
The Centers for Disease Control and Prevention continues to recommend annual vaccination as the best tool for preventing influenza, as well as timely use of antiviral medications to treat influenza in select patients. While antiviral drugs can help reduce the duration and severity of flu symptoms, the decision to use them must be based on individual evaluations of risk and benefit.
Marketing Page Webinar - Diagnosis and Management of Obstructive Sleep Apnea: When are Sleep Studies Medically Necessary?
Estimates indicate that as many as 18 million Americans suffer from sleep apnea. Sleep abnormalities can lead to declines in quality of life, diminished waking performance, more frequent illness, and increases in both morbidity and mortality. Despite the high prevalence of sleep disorders, sleep complaints often remain under-addressed.
Marketing Page Webinar - Intensity-Modulated Radiation Therapy (IMRT): When Is IMRT Medically Necessary?
IMRT controls, or modulates, the intensity of the radiation beam to match the exact 3D geometrical shape of the tumor, including concave and complex shapes. The use of IMRT has increased significantly in the past decade. Although data support the use of IMRT to optimize outcomes and reduce toxicities for certain cancers, the procedure has recently come under government scrutiny for its high cost and because some physicians refer patients to facilities in which they have ownership stake.
Marketing Page Webinar - Improving Perinatal Health Outcomes for Women with Symptoms of Preterm Labor: Preterm Labor Assessment Toolkit
Although studies continue to show that babies born 39 to 40 weeks gestational age experience better outcomes than infants born earlier, there is still wide variation in the practices used to assess pregnant women presenting with symptoms of preterm labor. The March of Dimes has developed a Preterm Labor Assessment Toolkit to help practitioners establish a standardized clinical pathway for women with suspected preterm labor. Improved identification of women in preterm labor will not only provide timely and appropriate interventions, but also promote effective management to improve neonatal outcomes.
Marketing Page Webinar - The Use of Erythropoiesis-Stimulating Agents (ESAs) for the Treatment of Anemia of Chronic Kidney Disease: When are ESAs Medically Necessary?
Although the use of ESAs to treat anemia of CKD can improve quality of life and may eliminate the need for blood transfusion and its associated risks, it is not without controversy. Some studies suggest that ESAs may increase the risk of potentially life-threatening complications, such as cardiovascular disease. This has resulted in a recent shift toward a more cautious approach to prescribing ESAs for patients with anemia of CKD.
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