The administrative burden of utilization review processes like prior authorizations and concurrent review has long been a thorn in the side of healthcare providers. While prior authorizations have ...

Ryan Haumschild, PharmD, MBA, MS: Prior authorizations are something that we’re used to on the payer side. Our health care providers don’t always get excited about them, but what they do is allow us ...

Mavenlink, a provider of cloud-based software for the modern services organization, is launching the Personal Utilization Manager with new capabilities that enable team members to manage and gauge ...

“Many employers and their health plan members assume that a utilization management program’s only goal is to approve or deny medical procedures and save costs for the health plan. In reality, ...

Yet there is positive momentum building against these trends as healthcare organizations look to reinvigorate many value-based care avenues like utilization management. Defined as the group of ...

Findings of a survey of large employers indicate that utilization management tools are ineffective in controlling health care costs for employees and may lead to barriers to treatment. Employer ...

Utilization management in Medicare Part D has become more restrictive over the last decade, even when compared to Medicare Advantage prescription drug plans, according to a new study. The study, ...

Washington, DC, Nov. 18, 2020 (GLOBE NEWSWIRE) -- URAC is widely recognized by nearly every state and the federal government for health utilization management. Earning the URAC Health Utilization ...

Although the literature has investigated utilization management practices, how they align with clinical practice guidelines is not well understood. 10, 11 A better understanding of this alignment ...

PALM BEACH GARDENS, Fla.--(BUSINESS WIRE)--Dane Street, a national leader in Independent Medical Exams and Reviews, announced today that it has achieved Accreditation in Utilization Management from ...

BREA, Calif.--(BUSINESS WIRE)--NCH Management Systems, Inc., D/B/A New Century Health (NCH), a national leader in specialty care management, today announced it has been accredited in Utilization ...