Utilization review criteria definition

Utilization review criteria means any criteria, standards, protocols, or guidelines used by an insurer to conduct utilization review.
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Utilization review criteria means any criteria, standards, protocols, or guidelines used by a health care service plan to conduct utilization review.
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Utilization review criteria means patient placement
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Examples of Utilization review criteria in a sentence

  • Utilization review criteria will be based on many sources including medical policy and clinical guidelines.

  • Utilization review criteria that are proprietary shall be subject to oral disclosure only.

  • Utilization review criteria, which are based on DDMHS practice guidelines and/or reasonable scientific evidence, are clearly documented, are reviewed at specific intervals, and are available to practitioners and consumers and family members upon request.

  • Utilization review criteria would mean any criteria, standards, protocol, or guidelines used by an insurer to conduct utilization review.

  • Utilization review criteria are based on reasonable medical evidence and are used to make decisions pertaining to the utilization of services.

  • The final fair value assessment of the transferred assets and liabilities have not yet been made.

  • I would have preferred not being thrown into the deep end of a bunch of new technology, I can do that myself outside of class.

  • Learning action-related object propertiesAmong the very first attempts to exploit robot actions to improve object perception is the work of Krotkov [166].

  • Many wire insulation and cable jacketing compositions contain materials, such as lead, halogenated compounds, and other ingredients, that impart electrical insulation and fire performance properties, but that have been identified as materials of potential environmental concern or as materials for which industry stakeholders have expressed a desire to identify and evaluate various alternatives.

  • Utilization review criteria shall be applied consistently by a carrier or the utilizationreview organization.


More Definitions of Utilization review criteria

Utilization review criteria means any criteria, standards, protocols, or guidelines used by
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Utilization review criteria means any criteria, standards,
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Utilization review criteria means any criteria, standards, protocols, or guidelines
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Utilization review criteria means any criteria, standards, protocols, or guidelines used by a health carrier to conduct utilization review.
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Related to Utilization review criteria

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

  • Utilization review means the prospective (prior to), concurrent (during) or retrospective (after) review of any service to determine whether such service was properly authorized, constitutes a medically necessary service for purposes of benefit payment, and is a covered healthcare service under this plan. WE, US, and OUR means Blue Cross & Blue Shield of Rhode Island. WE, US, or OUR will have the same meaning whether italicized or not. YOU and YOUR means the subscriber or member enrolled for coverage under this agreement. YOU and YOUR will have the same meaning whether italicized or not.

  • Independent educational evaluation means an evaluation conducted by a qualified examiner who is not employed by the public agency responsible for the education of the child in question.

  • Performance Tests means the tests to be conducted on the equipment at site for checking the performance parameters of the equipment as defined in Technical Specification.

  • Monitoring Indicator means a measure of HSP performance that may be monitored against provincial results or provincial targets, but for which no Performance Target is set;