The typical case management department is responsible for utilization management ... care and a lengthy and frequently unsuccessful appeals process, extending the days in accounts receivable.

Assessing differences in utilization management ... process works is this: You have to have a similar specialty physician reviewing the case with the provider, and they can do a formal appeal.

The letter accompanied a report on the TRICARE appeals process that Congress ... a better system to manage work flow and increase efficiency in case management, Wright wrote.

an efficient appeals process, and integrating the PA process into electronic health records for authorization at the point of care. Utilization management policies must protect patient access to ...

costly and time-consuming rounds of provider appeals. These inefficiencies cause distress to patients and health systems alike – especially crucial clinical staff like utilization management ...