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.

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 ...