Utilization review program means a program for conducting utilization reviews by a private review
Utilization review program means a program established
Examples of Utilization review program in a sentence
UBH, Payor or Provider shall comply with applicable provisions of Illinois laws and regulations as they relate to utilization review of health care services, including but not limited to those set forth in 215 ILCS 134/85 (Utilization review program registration).
United, Payer or Provider shall comply with applicable provisions of Illinois laws and regulations as they relate to utilization review of health care services, including but not limited to those set forth in 215 ILCS 134/85 (Utilization review program registration).
More Definitions of Utilization review program
Utilization review program means an overview of the activities performed by the private review agent.
Utilization review program means the program established for daily or frequent review and monitoring of Covered Services being managed and/or arranged by IPA. This review includes precertification, concurrent and retrospective review and may include telephonic review as well as on-site review.
Utilization review program. ’ means a system of re-
Utilization review program. A utilization review program has been established to review the medical necessity of Covered Services furnished by Specialist's affiliated with Provider Group to Members on an inpatient and outpatient basis. Such program includes pre-admission, concurrent and retrospective review and is in addition to any utilization review program required by a contracting Plan. Provider Group shall require its Specialist's to comply with such utilization review program.
Utilization review program. The utilization review program adopted by Medtrust and administered by DHS or its agents for the determination of the medical necessity of medical services provided to Members, or a similar program developed, established and administered by a Payor.
Utilization review program means a system of reviewing the
Utilization review program will mean the programs and processes established and carried out by Health Plan. Hospital and Plan Physicians, and approved by Health Plan, to evaluate, authorize and monitor the utilization of Covered Services provided to Enrollees.