Because doctors may appeal denial of payment for tests and services, utilization management staff must have a standard process for handling these appeals. Advertisement Article continues below this ad ...

Our goal is to make sure that we get everybody engaged and started in the process and we have a good utilization management process. ... to process multiple prior authorizations and appeals, ...

Ensure finance representation and participation in the hospital’s utilization management committee to support case management processes and system-wide process improvement.

“We seek to create a more proactive, versus reactive, case management process,” Ms. Mehrabian said. Change Healthcare released InterQual AutoReview, a software solution to automate the medical ...

DENVER--(BUSINESS WIRE)--Sagility, LLC, a technology-enabled healthcare business process management (BPM) company, has announced the launch of its Utilization Management as a Service (UMaaS ...

Successful complaint resolution and utilization management review might eliminate most deficits associated with complaints and denied care, ... The denial and appeals process offers patients, ...

Achieving URAC’s HUM accreditation underscores our dedication to delivering fair, impartial, and efficient healthcare review services,” said Jim Bobeck, Esq., CEO of FHAS. “It reinforces our superior, ...

Of the 124 cases that made it to the final stage of the appeals process from fiscal 2009 to fiscal 2013, the Defense Health Agency adopted in full the hearing officer’s decision to grant payment ...

Zuniga v. WCAB (Interactive Trucking, Inc.), 2018 A143290 confirms that Labor Code Section 4610.6(f) prevents the Workers’ Compensation Appeals Board ...