Retrospective DUR definition

Retrospective DUR means that part of the drug utilization review program that assesses or measures drug use based on an historical review of drug use data against predetermined and explicit criteria and standards, on an ongoing basis with professional input.
Retrospective DUR means a retrospective review of Members’ prescription claims to evaluate the appropriateness of each Member’s therapy based upon generally accepted current clinical pharmacy practices and clinical rules that focus on gaps in care and unsafe and clinically inappropriate therapy across widely utilized therapy classes.

Examples of Retrospective DUR in a sentence

  • Retrospective DUR criteria may include Pharmacy Management (Lock-In), Polypharmacy, and Psychotropic Use in Children.

  • Retrospective DUR Program Retrospective DUR (RetroDUR) Program requirements are provided in the Contract.

  • Retrospective DUR shall utilize telephonic or written interventions with prescribers to determine medical necessity for prescribed medications.

  • We describe a pilot implementation of Level Three: Improved Retrospective DUR Programming and Clinical Case Management (“Level Three”).

  • Retrospective Utilization Review Retrospective DUR activities are implemented after medications have been dispensed to health plan members.

  • The two components of New York State's DUR Program are Retrospective DUR (RetroDUR) and Prospective DUR (ProDUR).

  • ESI currently does not provide Current DUR Savings or Retrospective DUR reports monthly for PEBP; however, the ESI clinical pharmacist does provide physicians with reporting to encourage increased generic and formulary prescribing.

  • Attachment 2 – Retrospective DUR Educational Outreach Summary‌This is a year-end summary report on RetroDUR screening and educational interventions.

  • Retrospective DUR includes, but is not limited to, using predetermined standards to monitor the following: therapeutic appropriateness, over-utilization and under-utilization, appropriate use of generic products, therapeutic duplication, drug-disease contraindications, drug/drug interaction, incorrect drug dosage, incorrect duration of drug treatment, and clinical abuse and misuse.

  • Retrospective DUR examines drug use after the drug has been dispensed.

Related to Retrospective DUR

  • Retrospective review means a review of medical necessity conducted after services have been provided to a patient, but does not include the review of a claim that is limited to an evaluation of reimbursement levels, veracity of documentation, accuracy of coding, or adjudication for payment.

  • Retroactive Date means the date specified in the Schedule.

  • Premium surcharge means a payment required from a subscriber, in addition to the subscriber's medical premium contribution, due to an enrollee's tobacco use or an enrolled subscriber's spouse or state registered domestic partner choosing not to enroll in their employer- based group medical when:

  • child tax credit means a child tax credit under section 8 of the Tax Credits Act 2002;

  • Special Reimbursement Date means, the special payment date established in connection with a Reimbursement under Special Circumstances as described hereunder “Extraordinary Events and Special Circumstances – Reimbursement Under Special Circumstances and Payment”.

  • Premium Due Date means date specified in the Schedule on which the Instalment Premium will become due.

  • Premium tax means a tax paid by insurance companies to provincial and territorial governments calculated as a percentage of gross premiums written.

  • Extra Premium means an additional amount charged by Us, as per Our Underwriting Policy, which is determined on the basis of disclosures made by You in the Proposal Form or any other information received by Us including medical examination report of the Life Insured.

  • Insurance Cost Increase shall not, however, include any premium increases resulting from the nature of the occupancy of any other lessee of the Building. If the parties insert a dollar amount in Paragraph 1.9, such amount shall be considered the "BASE PREMIUM." If a dollar amount has not been inserted in Paragraph 1.9 and if the Building has been previously occupied during the twelve (12) month period immediately preceding the Commencement Date, the "Base Premium" shall be the annual premium applicable to such twelve (12) month period. If the Building was not fully occupied during such twelve (12) month period, the "Base Premium" shall be the lowest annual premium reasonably obtainable for the Required Insurance as of the Commencement Date, assuming the most nominal use possible of the Building. In no event, however, shall Lessee be responsible for any portion of the premium cost attributable to liability insurance coverage in excess of $1,000,000 procured under Paragraph 8.2(b).

  • Inflation means the percentage change in the implicit price

  • Yearly (1/Year) sampling frequency means the sampling shall be done in the month of September, unless specifically identified otherwise in the effluent limitations and monitoring requirements table.

  • Risk Premium means a percentage determined on an Adjustment Day for the Adjustment Period beginning on such Adjustment Day, which indicate the price of the risks taken over by the Issuer. The determination will be made by the Issuer in its reasonable discretion (billiges Ermessen § 315 German Civil Code (BGB)). The respective

  • Cost Reimbursement means a contract which provides for a fee other than a fee based on a percentage of cost and under which a contractor is reimbursed for costs which are allowable and allocable in accordance with the contract terms.

  • High Deductible Health Plan means a Health Plan as defined by 26 USC § 223(c)(2)(A) that also is a Qualified Health Plan.

  • Coinsurance means that you pay a percent of the total cost of the drug each time you fill a prescription.

  • Yearly (1/Year) sampling frequency means the sampling shall be done in the month of September, unless specifically identified otherwise in the effluent limitations and monitoring requirements table.

  • Premiums means premiums, considerations, deposits and similar receipts with respect to the Policies or Post-Closing Policies.

  • Minor Change means an amendment of an existing authorisation that is not of a purely administrative nature and requires only a limited re-assessment of the properties or efficacy of the biocidal product or biocidal product family;

  • Material Change in Formula means the occurrence since the Launch Date of a material change in the formula for, or the method of, calculating the Reference Price.

  • Enrollee point-of-service cost-sharing means amounts paid to

  • Rebates means rebates, price reductions, administrative fees and related adjustments charged by federal, state and local governmental programs and their participants, and by health plans, insurance companies, mail service pharmacies and health care providers based upon the utilization and sales of the Products, and service, administrative and inventory management fees due to wholesalers, distributors and group purchasing organizations based on sales of the Products.

  • R&W Policy means a representation and warranty insurance policy for the benefit of Buyer obtained in connection with this Agreement on the terms described on Schedule 1.01 of the Buyer Disclosure Schedule.

  • Input Tax Credit means the credit of input tax;

  • Disciplinary change in placement means a suspension or removal from a student’s current educational placement that is either:

  • Major Change means any event or proposed modification that, in the opinion of the Fund, will involve a major change in, or a restructuring of, a Funded Activity’s scope, structure, design or objectives, including a reallocation of GCF Proceeds beyond the threshold set out in the relevant FAA affecting the Funded Activity’s scope or objectives, or any other change that substantially alters the purpose or benefit of the Funded Activity, in each case, as may be described in detail in the relevant FAA;

  • Base flood means the flood having a one percent chance of being equaled or exceeded in any given year.