Utilization Review (utilization Management)

Definition of "Utilization review (utilization management)"

Integral part of managed care health plans designed to control and limit medical expenses. This review includes: requirement of certification for admission to a health care facility; continuous analysis of the reasons for the patient to remain in the health care facility; projected date for release of the patient; and cost-effective ways of handling patients with catastrophic illnesses.

image of a real estate dictionary page

Have a question or comment?

We're here to help.

*** Your email address will remain confidential.
 

 

Popular Insurance Terms

Program of health care designed for the prevention and/or reduction of illnesses by providing such services as regular physical examinations. This care is in opposition to curative care, ...

Measure of policyholder interest in a variable annuity policy prior to the annuity date. This measure is similar to a unit in a mutual fund. ...

Work-related accident. Occupational accidents that injure employees are the responsibility of the employer and are covered by workers compensation insurance. In recent years, the term ...

Investments restricted to short-term financial instruments issued by state, city, and county governments and agencies. Interest paid by those instruments are not subject to federal income ...

Coverage in which an applicant lot required to take a medical examination, instead answers written questions to ascertain his current physical condition. ...

Report developed by or supplied by a credit agency to an insurer dealing with the financial standing and character of an insurance applicant. These factors are carefully weighted by the ...

Figure in a mortality table derived by dividing the number of people alive at the end of a given year by the number of people alive at the beginning of that same year. ...

Insurance policy under which the value equals the benefits to be paid to the plan participants (employees) at normal retirement age, assuming that (1) their rate of earnings remains the ...

Payment of premiums and benefits as they come due. In pension plans, known as the "pay as you go basis." The plan depends on new employees coming into the work force so that their ...

Popular Insurance Questions