Utilization review organization means an entity that conducts utilization review, other than a health carrier performing a review for its own health plans.
Independent review organization means an entity that is accredited to conduct independent external reviews of adverse benefit determinations.
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.
Utilization review plan or "plan" means a written procedure for performing review.
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.
Independent System Operator means a person that may receive or has received, by transfer pursuant
Managed care organization means an entity that (1) is under contract with the department to provide services to Medicaid recipients and (2) meets the definition of “health maintenance organization” as defined in Iowa Code section 514B.1.
independent review committee means the independent review committee of the investment fund established under National Instrument 81-107 Independent Review Committee for Investment Funds;
Stewardship organization means an organization, association, or
Independent testing laboratory means an independent organization, accepted by the Contracting Officer, engaged to perform specific inspections or tests of the work, either at the site or elsewhere, and report the results of these inspections or tests.
Procurement organization means an eye bank, organ procurement organization, or tissue bank.
Peer support specialist means an individual who has experienced a severe and persistent mental illness and who has successfully completed standardized training to provide peer support services through the medical assistance program or the Iowa Behavioral Health Care Plan.
Professional employer organization means any person that enters into a written agreement with a
Evaluation Team means the team appointed by the City; “Information Meeting” has the meaning set out in section 2.2;
Managed care plan means a health benefit plan that either requires a covered person to use, or