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.
It is gratifying that AHS has decided to roll out the
Utilization Management System across all the acute-care beds throughout the province.
Our focus has shifted, necessarily, from
utilization management to quality assurance.
By applying for and receiving Health
Utilization Management Accreditation, Univita has demonstrated a commitment to quality health care," said Alan P.
HMS has provided
utilization management services to Ohio since 1997.
URAC Health
Utilization Management Accreditation is an important milestone for ITA which demonstrates our ongoing commitment to ensuring the delivery of quality care for all participants in the cancer care process," said Eduardo Beruff, chief executive officer and president of ITA Partners, Inc.
The Failure of Illness S-Curve
Utilization Management Efforts
Designed around a patient-aware health management philosophy, MEDecision's solutions include Alineo([R]), a collaborative healthcare management platform for delivering outcome-driven case, disease and
utilization management, Nexalign([R]), a collaborative healthcare decision support service that fosters better payer-patient-physician interactions and InFrame[TM], a collaborative health information exchange service that connects care delivery organizations with one another and their patients.
Enrollees must also be educated regarding
utilization management and the interplay between
utilization management and quality assurance.
ACM[R]) announced today that it has been awarded Health
Utilization Management Accreditation by URAC, a leading health care accrediting organization that establishes quality standards for the health care industry.
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.
