Any utilization review nurses working at an insurance company able to share if your company requires work on weekend/holidays? If so, what work do you do on weekend/holidays snd do you work s full day on those days?

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Depends on the company but I can say it's very uncommon in worker's compensation insurance

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The small insurance I work for requires holiday and weekend work. No one has been able produce actual written requirements from state or federal agencies that says it’s even necessary. So I wanted to hear from UR nurses who work at other insurance companies.

Our UM doesn’t work weekends but the caseload is average to high for most teams.

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Thank you for your response. We are a very small insurance compared to BCBS. We are told it’s a requirement of CMS. We do concurrent reviews of new notifications on weekends/holidays. Our impatient team is very small (only 5 nurses) so our work load is very heavy. We do not do just the initial review, we also follow the member during hospitalization, do discharge planning as well as pre-auths for SNF and Acute. I’ve always asked if someone could check in with a bigger insurance to see what they do because I have a feeling that this weekend tule should be.

No, ours does not require it.

Thank you for your response. Would you be able to tell me what company it is or at least if it’s a big (national) health insurance company?

Our company does not require it either. I think it really depends on the company.

Our health insurance company is very small, less than 200K members. It is only the nurses that work weekends because the company says it’s a CMS, NCQA and DOI requirement. Which one would think would be the same requirement for all health insurance companies.

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