Common use of Benefits Management Program Clause in Contracts

Benefits Management Program. The Benefits Management Program applies utilization management and case management principles to assist Members and providers in identifying the most appropriate and cost-effective way to use the Benefits provided under this health plan. The Benefits Management Program includes prior authorization requirements for inpatient admissions, selected inpatient and outpatient services, office- administered injectable drugs, and home-infusion- administered drugs, as well as emergency admission notification, and inpatient utilization management. The program also includes Member services such as, discharge planning, case management and, palliative care services. The following sections outline the requirements of the Benefits Management Program.

Benefits Management Program. The Benefits Management Program applies utilization management and case management principles to assist Members and providers in identifying the most appropriate and cost-effective way to use the Benefits provided under this health plan. The Benefits Management Program includes prior authorization requirements for inpatient admissions, selected inpatient and outpatient services, office- office-administered injectable drugs, and home-infusion- infusion-administered drugs, as well as emergency admission notification, and inpatient utilization management. The program also includes Member services such as, discharge planning, case management and, palliative care services. The following sections outline the requirements of the Benefits Management Program.