utilization review


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Related to utilization review: Drug Utilization Review

utilization review

n.
A process for monitoring the use and delivery of services, especially one used by a managed care provider to control health care costs.

utilization review (UR)

[yo̅o̅′tilīzā′shən]
Etymology: L, utilis + atus, process
an assessment of the appropriateness and economy of an admission to a health care facility or a continued hospitalization. The length of the hospital stay also is compared with the average length of stay for similar diagnoses.

utilization review

Utilization control, utilization management Managed care Evaluation of the necessity–eg, for surgery or other therapy, appropriateness–of admissions or of services ordered, and efficiency of the use of health care services, procedures, and facilities. See Utilization.

utilization review

Evaluation of the necessity, quality, effectiveness, or efficiency of medical services, procedures, and facilities. In regard to a hospital, the review includes appropriateness of admission, services ordered and provided, length of stay, and discharge practices.
References in periodicals archive ?
The pharmacy adjudicates prescription and checks Drug Utilization Review (DUR) edits.
The key to appropriate application of utilization review is the ability to use data analytics to identify, the providers whose treatment does not need to be "micromanaged" versus those whose treatment patterns are more questionable--and then apply a targeted utilization-review program accordingly.
Depose this medical specialist, as well as the company's specialists on utilization review, utilization management, quality assurance, and advertising both in general and with respect to your client's case.
In addition, Clifton developed the nation's first Peer and Utilization Review Organization devoted to physical therapy and rehabilitation.
The OWNER is soliciting proposals for Utilization Review Services for its employees covered by the Self funded Health
California based MediCall, a specialized healthcare services provider, today announced the latest progress in its nationwide utilization review (UR) program rollout with the addition of Texas.
California based MediCall, a specialized healthcare services provider, today announced that it has filed its Utilization Review (UR) Plan with the California Division of Workers' Compensation (DWC).
Last year, our organization hired a physician as a utilization review consultant.
In both cases, the physicians most frequently cited payment, paperwork and utilization review issues as their motivation.
His credentials include board certification in family medicine with CAQ in geriatrics and certification by the American Board of Quality Assurance and Utilization Review Physicians with subspecialty certification in managed care.
APS Healthcare, one of the country's leading specialty healthcare companies, today announced that it has been selected by the state of Maryland's Department of Health and Mental Hygiene, Developmental Disabilities Administration (DDA) to provide utilization review services for the state's Medicaid beneficiaries.
Rafiu Ariganjoye, MD, MBA, CHCQM, FAAP, successfully completed certification with the American Board of Quality Assurance and Utilization Review Physicians, Inc.