Utilization review plan or "plan" means a written procedure for performing review.
Utilization review plan means a description of the standards governing utilization
Utilization review plan means the written plan filed with the Administrative Director pursuant to Labor Code section 4610, setting forth the policies and procedures, and a description of the utilization review process.
Examples of Utilization review plan in a sentence
The Contractor shall implement a Utilization Management (UM) Program that meets the requirements set forth in this section and that is documented in a Utilization review plan as defined in KRS 304.17A-600.
The utilization review committee, consisting of the group of professional personnel specified in § 485.56(c), a committee of this group, or a group of similar composition, comprised by professional personnel not associated with the facility, must carry out the utilization review plan.(b) Standard: Utilization review plan.
More Definitions of Utilization review plan
Utilization review plan means a description of the procedures governing utilization review activities performed by an insurer or a private review agent.
Utilization review plan means a description of the procedures governing
Utilization review plan means a description of the standards governing utilization review activities performed by a review agent.
Utilization review plan means a description of utilization
Utilization review plan means: (1) a description of the process for developing the written clinical review criteria, (2) a description of the types of written clinical information which the plan might consider in its clinical review, including but not limited to a set of specific written clinical review criteria, (3) a description of practice guidelines and standards used by a Utilization Review Agent in carrying out a determination of medicalnecessity, (4) the procedures for scheduled review and evaluation of the written clinical review criteria, and (5) a description of the qualifications and experience of the health care professionals who developed the criteria, who are responsible for periodic evaluation of the criteria and of the health care professionals or others who use the written clinical review criteria in the process of Utilization Review.
Utilization review plan means the screening criteria and utilization review procedures of a utilization review agent.
Utilization review plan means a summary description of