Utilization Review PDF Download
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Author | : Stefani Daniels |
Publisher | : |
Total Pages | : 0 |
Release | : 2015-04-16 |
Genre | : Hospital utilization |
ISBN | : 9781556452147 |
Download The Hospital Guide to Contemporary Utilization Review Book in PDF, ePub and Kindle
The Hospital Guide to Contemporary Utilization Review is a comprehensive resource designed to identify utilization review (UR) best practices and provide guidance on developing and enhancing a contemporary UR committee. This book focuses on the latest UR and patient status requirements to help hospitals perform high-quality reviews and comply with regulations. The book covers a range of topics, including compliance with the UR Condition of Participation, legal obligations of a hospital, contract language, and compliant UR plan language to provide an understanding of the expectations of a UR program. Tips for intradepartmental collaboration are included to guide professionals through the process of selecting a physician advisor and partnering with nurses, case managers, and revenue cycle team members. This book will help you do the following: Identify the components of a best practice hospital utilization review (UR) program Describe the legal obligations of the hospital to comply with chapter 42 CFR 482.30 of the Conditions of Participation (CoP) Use the publication as a tool to assess his or her own hospital's UR processes Summarize the benefits of a dedicated UR team to promote compliance with the CoP Facilitate the development of a contemporary UR committee Assess an organization's opportunities to improve processes to benefit patient care and hospital success Recommend compliant language for the organization's UR plan Construct commercial contract language, in collaboration with the organization's contract manager, that promotes a partnership to ensure appropriate use of acute care resources Seek out operational resources to perform high-quality reviews that fully comply with the CoP Explain the connection between a good utilization review plan and the hospital revenue cycle initiatives
Author | : Institute of Medicine |
Publisher | : National Academies Press |
Total Pages | : 321 |
Release | : 1989-01-01 |
Genre | : Medical |
ISBN | : 0309040485 |
Download Controlling Costs and Changing Patient Care? Book in PDF, ePub and Kindle
Utilization management (UM) has become a strong trend in health care cost containment. Under UM, some decisions are not strictly made by the doctor and patient alone. Instead, they are now checked by a reviewer reporting to an employer or other paying party who asks whether or not the proposed type or location of care is medically necessary or appropriate. This book presents current findings about how UM is faring in practice and how it compares with other cost containment approaches, with recommendations for improving UM program administration and clinical protocols and for conducting further research.
Author | : Kent Lewandrowski |
Publisher | : Springer |
Total Pages | : 299 |
Release | : 2016-11-29 |
Genre | : Medical |
ISBN | : 3319341995 |
Download Utilization Management in the Clinical Laboratory and Other Ancillary Services Book in PDF, ePub and Kindle
This book is the first comprehensive text on utilization management in the clinical laboratory and other ancillary services. It provides a detailed overview on how to establish a successful utilization management program, focusing on such issues as leadership, governance, informatics, and application of utilization management tools. The volume also describes ways to establish utilization management programs for multiple specialties, including anatomic pathology and cytology, hematology, radiology, clinical chemistry, and genetic testing among other specialties. Numerous examples of specific utilization management initiatives are also described that can be imported to other heath care organizations. A chapter on utilization management in Canada is also included. Edited by an established national leader in utilization management, Utilization Management in the Clinical Laboratory and Other Ancillary Services is a valuable resource for physicians, pathologists, laboratory directors, hospital administrators, and medical insurance professionals looking to implement a utilization management program.
Author | : Navarro |
Publisher | : Jones & Bartlett Publishers |
Total Pages | : 659 |
Release | : 2008-12-11 |
Genre | : Medical |
ISBN | : 076378883X |
Download Managed Care Pharmacy Practice Book in PDF, ePub and Kindle
Managed Care Pharmacy Practice, Second Edition offers information critical to the development and operation of a managed care pharmacy program. The text also covers the changes that have taken place within the delivery of pharmacy services, as well as the evolving role of pharmacists.
Author | : United States. General Accounting Office |
Publisher | : |
Total Pages | : 100 |
Release | : 1992 |
Genre | : Administrative remedies |
ISBN | : |
Download Utilization Review Book in PDF, ePub and Kindle
Author | : Rona Beth Schumer |
Publisher | : |
Total Pages | : 130 |
Release | : 1971 |
Genre | : Health insurance |
ISBN | : |
Download Hospital Utilization Review and Medicare Book in PDF, ePub and Kindle
Author | : California. Legislature. Senate. Committee on Judiciary |
Publisher | : |
Total Pages | : 124 |
Release | : 1985 |
Genre | : Medicaid |
ISBN | : |
Download Interim Hearing on Utilization Review Book in PDF, ePub and Kindle
Author | : Michael Quinn Patton |
Publisher | : SAGE |
Total Pages | : 489 |
Release | : 2012 |
Genre | : Reference |
ISBN | : 141297741X |
Download Essentials of Utilization-Focused Evaluation Book in PDF, ePub and Kindle
"Provides both an overall framework and concrete advice for how to conduct useful evaluations that actually get used." - preface.
Author | : United States. Congress. Senate. Committee on Finance. Subcommittee on Health |
Publisher | : |
Total Pages | : 232 |
Release | : 1981 |
Genre | : Medicaid |
ISBN | : |
Download Proposed Phaseout of PSRO's and Utilization Review Requirements Book in PDF, ePub and Kindle
Author | : American Psychiatric Association. Committee on Managed Care |
Publisher | : American Psychiatric Pub |
Total Pages | : 84 |
Release | : 1992-01-01 |
Genre | : Medical |
ISBN | : 9780890422359 |
Download Utilization Management Book in PDF, ePub and Kindle
This handbook provides clinicians with timely and useful information that will help psychiatrists obtain optimal coverage of services for patients. Among the issues addressed are frequently encountered problems, confidentiality, contracting, and the process of utilization management.