Examples of Utilization review program in a sentence
Utilization review program-- For purposes of this title the term "utilization review program" means a system of reviewing the medical necessity, appropriateness, or quality of health care services and supplies provided under a health insurance plan or a managed care plan using specified guidelines.
Utilization review program for inpatient psychiatric services for clients under age twenty-one or age sixty-five or over (a) The department's Utilization Review Program conducts utilization review activities for services delivered by the inpatient psychiatric hospital to clients where the Medical Assistance Program has been determined to be the appropriate payer.
UBH, Payor or Provider shall comply with applicable provisions of Illinois laws and regulations as they relate to utilization review of health care services, including but not limited to those set forth in 215 ILCS 134/85 (Utilization review program registration).
Health Insurance Consumer Complaint Process New Mexico Patient Protection Act – N.M.S.A. 1978, § 59A-57-1• Passed in 1998• Broadly covers all health insurance plans offered in NM, including plans offered to public employees through Healthcare Purchasing Act• Provides for:• Transparency in health plan documents• Utilization review program requirements• Process for consumers to complain about coverage denials, delays, etc.
This is based on the sectoral (MSMEs) contribution to GDP, export and employment as reflected in the National Survey of MSMEs by 1POLICY BRIEFThe Effect of the African Continental Free Trade Area on Medium Small & Micro-scale Enterprises in Nigeria National Bureau of Statistics (NBS, 2019).