Utilization review organization definition

Utilization review organization means an entity that conducts utilization review, other than a health carrier performing a review for its own health benefit plans.
Utilization review organization means an entity that conducts utilization review, other
Utilization review organization means a person that conducts utilization review, other than a health carrier performing a review for its own health plans.

Examples of Utilization review organization in a sentence

  • Utilization review organization means an entity that conducts Utilization review, other than Us performing utilization review for Our own health benefit plans.There are 3 types of claims: Pre-Service, Concurrent Care, and Post-Service Claims.

  • Techniques may include ambulatory review, prospective review, second opinion, certification, concurrent review, case management, discharge planning, or retrospective review.(ff) "Utilization review organization" means a person that conducts utilization review, other than a health carrier performing a review for its own health plans.

  • Utilization review organization" means an entity that conducts utilization review, other than a health carrier performing a review for its own health plans.

  • Utilization review organization" means an entity that conducts a utilization review, other than a carrier performing a utilization review for its own health benefit plans.[PL 2019, c.

  • Utilization review organization means an entity that conducts Utilization review, other than Us performing utilization review for Our own health benefit plans.Complaint SystemWithin 180 days after notice of an adverse determination of a claim, the covered person, or an authorized representative may file a written or oral complaint by sending Us a written request for review.


More Definitions of Utilization review organization

Utilization review organization means an entity that conducts utilization review, other than a health insuring corporation performing a review of its own health care plans.
Utilization review organization means an entity that con- ducts utilization review, other than an insurer or pharmacy benefit manager performing utilization review for its own policy or plan.
Utilization review organization means an entity that
Utilization review organization means an entity that conducts utilization review for one or more of
Utilization review organization means an entity that provides utilization review services.
Utilization review organization means an entity that conducts utilization review, other than a health
Utilization review organization means an entity that conducts a utilization review, other than a carrier performing a utilization review for its own health benefit plans. [PL 2019, c. 295, §1 (NEW); RR 2019, c. 1, Pt. A, §26 (RAL).]