utilization management


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Related to utilization management: utilization review

u·ti·li·za·tion man·age·ment

(yū'ti-lī-zā'shŭn man'ăj-mĕnt)
Review of appropriateness and necessity of care provided to inpatients
References in periodicals archive ?
Although the traditional approach to utilization management as described above is still prevalent in many parts of the country, health care providers are examining and retooling their processes to eliminate the duplication of effort in chart review and enhance assessment of patient needs.
While a significantly higher figure may not mean inappropriate utilization, this possibility at least should be discussed with the client's insurance carrier or utilization management organization.
Our focus has shifted, necessarily, from utilization management to quality assurance.
The Failure of Illness S-Curve Utilization Management Efforts
Enrollees must also be educated regarding utilization management and the interplay between utilization management and quality assurance.
Electronic processing of claims and electronic access to claims data by other departments of the health plan, including member services, provider services, and utilization management, is essential to do business most efficiently.