UTILIZATION MANAGEMENT

Utilization Management

Utilization Management

Introduction

Concurrent Utilization Review (UR) is a process that helps determine the most effective utilization by the hospital. (Murray 2001)Utilization includes the services that will be rendered and especially the length of stay that will allow for maximum recovery to the patient but minimum cost to the hospital. It also helps the insurer determine how much if any of the service will be covered.

The process has many benefits ? but there is a tendency in hospitals to over think the process and often put too many resources into utilization review that don't justify the amount of return that the ...