Utilization review plan definition

Utilization review plan or "plan" means a written procedure for performing review.

Utilization review plan means a description of the standards governing utilization

Utilization review plan means the written plan filed with the Administrative Director pursuant to Labor Code section 4610, setting forth the policies and procedures, and a description of the utilization review process.

Examples of Utilization review plan in a sentence

• Utilization review plan" means a description of the procedures governing utilization review activities performed by an insurer or a private review agent.

• Utilization review plan" means a description of the standards governing utilization review activities performed by a review agent.

• Th e pl an m u s t p r ovide t ha t r eco r ds be m a i n t a i n ed of a ll m ee t i n gs, decisio n s, an d a c t io n s b y t h e u t iliza t io n r eview co mm i tt ee.( a) Standard: Utilization review plan.

• Areas of review 9 include concurrent, prospective, and retrospective review; and 10 (18) "Utilization review plan" means a description of the procedures governing 11 utilization review activities performed by an insurer or a private review agent.

• The Contractor shall implement a Utilization Management (UM) Program that meets the requirements set forth in this section and that is documented in a Utilization review plan as defined in KRS 304.17A-600.

More Definitions of Utilization review plan

Utilization review plan means a description of the procedures governing utilization review activities performed by an insurer or a private review agent.

Utilization review plan means a description of the procedures governing

Utilization review plan means a description of the standards governing utilization review activities performed by a review agent.

Utilization review plan means: (1) a description of the process for developing the written clinical review criteria, (2) a description of the types of written clinical information which the plan might consider in its clinical review, including but not limited to a set of specific written clinical review criteria, (3) a description of practice guidelines and standards used by a Utilization Review Agent in carrying out a determination of medicalnecessity, (4) the procedures for scheduled review and evaluation of the written clinical review criteria, and (5) a description of the qualifications and experience of the health care professionals who developed the criteria, who are responsible for periodic evaluation of the criteria and of the health care professionals or others who use the written clinical review criteria in the process of Utilization Review.

Utilization review plan means a description of utilization

Utilization review plan means the screening criteria and utilization review procedures of a utilization review agent.

Utilization review plan means a description of the policies and procedures governing utilization review activities performed by a private review agent.