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.
References in periodicals archive ?
In fact, several states have designated URAC as their accreditor of workers compensation utilization review.
David Allara MD offering our new Utilization review 101 class and our new Pharmacology 101 class to our students,” Cali Estes, CEO, said.
By putting a drug utilization review program into place, auto no-fault insurers could receive significant incremental savings--usually between 10% and 15% above the prescription cost savings.
However, loosening utilization review is not without cost, she said.
Hiestand said that the doctors intentionally withheld the fact that a utilization review board makes all decisions on whether a patient could see a specialist, and Ruschell relied on that information.
Some studies show global pricing is a more cost-effective tool than negotiated discounts or utilization review.
Here is a typical experience with the utilization review process, as culled from Consumer Reports for August 1992.
The survey found that managed care programs, which include utilization review and health maintenance organization/preferred provider organization delivery systems, are the most prevalent strategy used by self-insured companies to control rising costs.
While still providing URAC-accredited utilization review services, CID has expanded its offerings to include per-incident and enterprise-level clinical services known as The Clinical Experience.
Department of Industrial Relations Director Christine Baker today released the following statement on SB 1160 (Mendoza), legislation which makes substantial reforms to the utilization review process used to contest care to injured workers.