Utilization review companies must be registered in the state in which the review will be done. Guidelines used for making reviews should be available to those physicians. Individuals conducting reviews should be board certified in those specialties they are reviewing, and practice within the same community. If a difference of opinion still exists between the reviewer and the practicing physician, a second-opinion examination should be required by a board certified otolaryngologist in active practice or board certified surgeon in a related and appropriate discipline and in active practice.
Important Disclaimer Notice
Position statements are approved by the American Academy of Otolaryngology—Head and Neck Surgery, Inc. or Foundation (AAO-HNS/F) Boards of Directors and are typically generated from AAO-HNS/F committees. Once approved by the Academy or Foundation Board of Directors, they become official position statements and are added to the existing position statement library. In no sense do they represent a standard of care. The applicability of position statements, as guidance for a procedure, must be determined by the responsible physician in light of all the circumstances presented by the individual patient. Adherence to these clinical position statements will not ensure successful treatment in every situation. As with all AAO-HNS/F guidance, this position statement should not be deemed inclusive of all proper treatment decisions or methods of care, nor exclusive of other treatment decisions or methods of care reasonably directed to obtaining the same results.
Workshops held in cities nationwide will help otolaryngologists, their staff, and other healthcare professionals code correctly, learn risk reduction strategies, and organize business systems.