Physician Review definition

Physician Review or “PR,” which means the physician- rendered review of proposed medical treatment by a physician licensed and qualified to render decisions to approve, adjust or deny such treatments, in accordance with nationally recognized treatment guidelines. PR includes the rendering and communication of such determinations to statutorily-required parties (including but not limited to claims adjusters, injured workers, physicians and medical facilities, attorneys and AC TRANSIT), in compliance with jurisdictional statutes and regulations.
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Physician Review or “PR,” which means the physician-rendered review of proposed medical treatment by a physician licensed and qualified to render decisions to approve, adjust or deny such treatments, in accordance with nationally recognized treatment guidelines. PR includes the
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Physician Review or “PR,” which means the physician-rendered review of proposed medical treatment by a physician licensed and qualified to render decisions to approve, adjust or deny such
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Examples of Physician Review in a sentence

  • During the Term of this Agreement, Resident/Fellow Physician shall, during the hours assigned to Resident/Fellow Physician by the Program Director (including night float or night call), perform the duties outlined in this Agreement at such locations as Hospital directs for the purpose of educating the Resident/Fellow Physician, delivering and participating inpatient care, and complying with the recommendations and policies of the applicable Program Residency/Fellow Physician Review Committee.

  • CMS will provide for some or all of the following services for Plan Participants upon the terms and conditions stated below: Utilization Management, Case Management, Disease Management, PBM Negotiations, Pre-determination or Retro-active Review, Predictive Risk Assessment, Physician Review, Clinical Telephonic Assistance, Diabetic Monitoring and other related services.

  • During the Term of this Agreement, Resident Physician shall, during the hours assigned to Resident Physician by the Program Director (including night float or night call), perform the duties outlined in this Agreement at such locations as Hospital directs for the purpose of educating the Resident Physician, delivering and participating in inpatient care, and complying with the recommendations and policies of the applicable Program Residency Physician Review Committee.

  • UR - Physician Review $185.00 per hour, with all hourly fees capped at a 0.80 hours per review average cost per quarter.

  • Clinical Prior Authorizations Technician/Pharmacist Review $50 per review State-mandated Physician Review $135 per review Prior Authorization Appeals Internal Clinical Appeals Requiring Physician Review $325 per review External clinical appeal $500 per review Bundled Cost of $0.17 PMPM Medication Adherence Program Opioid Risk Management Solution Utilization Management Standard UM/transactional fees Enhanced cDUR Standard included.