Utilization Management Department definition

Utilization Management Department or “UMD” means appropriately licensed COUNTY staff 30 and/or COUNTY contracted staff responsible for the coordination of services as well as the concurrent 31 and retrospective utilization review of the medical appropriateness, level of care, and utilization of all 32 services provided to MSI Patients by All Providers. 33 34 II. CLINIC OBLIGATIONS Clinic Clinic
Sample 1
Utilization Management Department or “UMD” means appropriately licensed COUNTY staff 30 and/or COUNTY contracted staff responsible for the coordination of services as well as the concurrent 31 and retrospective utilization review of the medical appropriateness, level of care, and utilization of all 32 services provided to MSI Patients by All Providers. 33 34 II. CLINIC OBLIGATIONS 35 A. CLINIC, billing for Medical Services for which reimbursement is provided through this 36 Agreement, shall provide Medical Services to all indigent persons covered by this Agreement presenting 37 for treatment. As a condition of reimbursement for Medical Services provided by CLINIC to MSI 1 Eligibles, CLINIC shall comply with this Agreement, including Exhibit E hereto. Claims for such 2 services shall be processed and reimbursed by Intermediary from the appropriate funding category in 3 accordance with Paragraph III. of this Exhibit B to this Agreement. ADMINISTRATOR may direct 4 Intermediary to withhold or delay payment due any CLINIC for failure to comply with the terms of this 5 Agreement.
Sample 1
Utilization Management Department or “UMD”, referred to as “Case Management Unit” 13 or “CMU” in Prior Agreement, means appropriately licensed COUNTY staff and/or COUNTY 14 contracted staff responsible for the coordination of services as well as the concurrent and retrospective 15 utilization review of the medical appropriateness, level of care, and utilization of all services provided to 16 MSI Patients by All Providers. 17
Sample 1

Examples of Utilization Management Department in a sentence

  • You may also write CareCheck® at Quality Utilization Management Department, 8170 33rd Avenue South, P.O. Box 1309, Minneapolis, MN 55440-1309.

  • Paramount’s Utilization Management Department is also available to assist You and/or Your Dependent student in locating providers outside of the Paramount Service Area; contact Utilization Management at (419) 887-2520 or 1-800-891-2520.

  • If your Dependent student needs medical care away from home that is not available from the student health center and it is not an emergency or urgent condition, before seeking services you or your Dependent student should contact our Utilization Management Department to obtain Prior Authorization.

  • Mid-State Health Network (MSHN)• MSHN’s Utilization Management Department is available Monday to Friday, 8am to 5pm at (844) 405-3095 for questions about benefits or services.• It is not required to call MSHN to start substance use services.

  • Inpatient services are available for medical detoxification, when medically necessary and are coordinated with IEHP’s Utilization Management Department.

  • Services from Out-of-Network Providers may be covered under In-Network Coverage only with prior written approval from Paramount’s Utilization Management Department.

  • Mid-State Health Network (MSHN)• MSHN’s Utilization Management Department is available Monday to Friday, 8am to 5pm at (844) 405-3095 for questions about benefits or services.• Note: It is not required to call MSHN to start substance use services.

  • If the question is about a specific utilization case or decision that cannot be answered by Customer Service, the Member’s call will be forwarded to the Utilization Management Department.

  • Platform to comply with all applicable standards of NeGD and will be security audited through a CERT-IN empanelled third party auditor or STQC.

  • Mid-State Health Network (MSHN)• MSHN’s Utilization Management Department is available Monday to Friday, 8:00 am to 5:00 pm at (844) 405-3095 for questions about benefits or services.• Note: It is not required to call MSHN to start substance use treatment services.

Related to Utilization Management Department

  • Utilization management section means “you or your authorized representative.” Your representative will also receive all notices and benefit determinations.

  • Fire Department means an organized fire department as that term is defined in section 1 of the fire prevention code, 1941 PA 207, MCL 29.1.

  • Stormwater management BMP means an excavation or embankment and related areas designed to retain stormwater runoff. A stormwater management BMP may either be normally dry (that is, a detention basin or infiltration system), retain water in a permanent pool (a retention basin), or be planted mainly with wetland vegetation (most constructed stormwater wetlands).

  • Virginia Stormwater Management Program or “VSMP” means a program approved by the State Board after September 13, 2011, that has been established by a locality to manage the quality and quantity of runoff resulting from land-disturbing activities and shall include such items as local ordinances, rules, permit requirements, annual standards and specifications, policies and guidelines, technical materials, and requirements for plan review, inspection, enforcement, where authorized in this article, and evaluation consistent with the requirements of this article and associated regulations.

  • Finance Department means the Finance Department of the Government of Assam;

  • Virginia Stormwater Management Program authority or "VSMP authority" means an authority approved by the State Board after September 13, 2011, to operate a Virginia Stormwater Management Program.

  • Stormwater management planning agency means a public body authorized by legislation to prepare stormwater management plans.

  • New Jersey Stormwater Best Management Practices (BMP) Manual or “BMP Manual” means the manual maintained by the Department providing, in part, design specifications, removal rates, calculation methods, and soil testing procedures approved by the Department as being capable of contributing to the achievement of the stormwater management standards specified in this chapter. The BMP Manual is periodically amended by the Department as necessary to provide design specifications on additional best management practices and new information on already included practices reflecting the best available current information regarding the particular practice and the Department’s determination as to the ability of that best management practice to contribute to compliance with the standards contained in this chapter. Alternative stormwater management measures, removal rates, or calculation methods may be utilized, subject to any limitations specified in this chapter, provided the design engineer demonstrates to the municipality, in accordance with Section IV.F. of this ordinance and N.J.A.C. 7:8-5.2(g), that the proposed measure and its design will contribute to achievement of the design and performance standards established by this chapter.

  • Police Department means the Police Department of the City and County of San Francisco.

  • Stormwater management system means any equipment, plants,

  • Stormwater management plan means the set of drawings and other documents that comprise all the information and specifications for the programs, drainage systems, structures, BMPs, concepts and techniques intended to maintain or restore quality and quantity of stormwater runoff to pre-development levels.

  • Local health department means the same as that term is defined in Section 26A-1-102.

  • Construction management at-risk means a project delivery method in which the District awards separate contracts, one for architectural and engineering services to design an infrastructure facility and the second to a construction manager at-risk for both construction of the infrastructure facility according to the design and construction management services.

  • Public Finance Management Act ’ means the Public Finance Management Act, 1999 (Act No. 1 of 1999);

  • Stormwater management means the programs to maintain quality and quantity of stormwater runoff to pre-development levels.

  • Project Management Report means each report prepared in accordance with Section 4.02 of this Agreement;

  • Supply Chain Management All aspects of supply chain management, from the initial sourcing phase through customer delivery (e.g., procurement, sourcing management, inventory management, catalog management, ordering/purchasing, invoice tracking, storefront/shopping cart, warehouse management, returns management, logistics/transportation).

  • Health Department means the department of environmental quality, a city health department, a county health department, or a district health department, whichever has jurisdiction.

  • Case management services means planned referral, linkage, monitoring and support, and advocacy provided in partnership with a consumer to assist that consumer with self sufficiency and community tenure and take place in the individual’s home, in the community, or in the facility, in accordance with a service plan developed with and approved by the consumer and qualified staff.

  • Stormwater management basin means an excavation or embankment and related areas designed to retain stormwater runoff. A stormwater management basin may either be normally dry (that is, a detention basin or infiltration basin), retain water in a permanent pool (a retention basin), or be planted mainly with wetland vegetation (most constructed stormwater wetlands).

  • Stormwater management planning area means the geographic area for which a stormwater management planning agency is authorized to prepare stormwater management plans, or a specific portion of that area identified in a stormwater management plan prepared by that agency.

  • Virginia Stormwater Management Act means Article 2.3 (§ 62.1-44.15:24 et seq.) of Chapter 3.1 of Title 62.1 of the Code of Virginia.

  • Project Management Plan means the management plan that (i) sets out a high level workplan to describe the manner in which the Design-Builder will manage the Project, including to address related matters such as traffic management and communications, and (ii) is prepared by or for the Design-Builder and submitted to the Owner;

  • Head of the Department means the administrative head of the department or the organization;

  • Electric provider means any of the following:

  • Storm water management plan means a comprehensive plan designed to reduce the discharge of pollutants from storm water after the site has under gone final stabilization following completion of the construction activity.