Examples of Utilization control in a sentence
Utilization control procedures safeguard against the delivery of unnecessary services, monitor quality, and ensure payments are appropriate and according to Texas Medicaid policies, rules, and regulations.
States will be asked to specify which managed care entities are used by the State in its managed care delivery system below in Section 3.1.2. Guidance: Utilization control systems are those administrative mechanisms that are designed to ensure that enrollees receiving health care services under the State plan receive only appropriate and medically necessary health care consistent with the benefit package.
Guidance: Utilization control systems are those administrative mechanisms that are designed to ensure that enrollees receiving health care services under the State plan receive only appropriate and medically necessary health care consistent with the benefit package.
Utilization control requirements for inpatient psychiatric services for members under 21 years of age apply to all hospitals and residential psychiatric treatment facilities.
Utilization control procedures for the on-going evaluation, on a sample basis, of the need for, and the quality and timeliness of care provided to Medicaid eligibles by the PIHP.
Utilization control procedures consistent with best practice standards and the three criteria stated below must be used.
Utilization control re- quirements for mental hospitals appear in subpart D.
States will be asked to specify which managed care entities are used by the State in its managed care delivery system below in Section 3.1.2. Guidance: Utilization control systems are those administrative mechanisms that are designed to ensure that enrollees receiving health care services under theState plan receive only appropriate and medically necessary health care consistent with the benefit package.
No change.) 10:52-1.16 Utilization control: inpatient psychiatric services for beneficiaries under 21 years of age in private psychiatric hospitals (a)-(b) (No change.) (c) The following words and terms, when used in this chapter, shall have the following meanings unless the context clearly indicates otherwise.
Services include, but are not limited to: ▪ Arranging appointments;▪ Building, equipment, and grounds maintenance;▪ Development, adoption, and posting of patient rights;▪ Development of disaster plans;▪ Development of patient councils;▪ Infection control;▪ Insect and vermin control;▪ Management of patient trust funds;▪ Nursing care determinations;▪ Quality control;▪ Record keeping; and▪ Utilization control.