Best Practice Utilization Management: 10 Tips for Success

Toni G Cesta

Best Practice Utilization Management: 10 Tips for Success

Beverly Cunningham

Healthcare
Jan 10, 2019
Feb 28, 2019
On-demand Webinar

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Key Points:

Business of case management
Difference between utilization review and utilization management
Compliance of utilization management
Access points for utilization management
Types of utilization management
Denial management
Incorporating utilization management into case management rules and functions
Physician relationships: Attending physician, consulting physician and physician advisor

Best Practice Utilization Management: 10 Tips for Success

Description:

Utilization management was the first role applied in acute care case management models. It was first known of as utilization review but has evolved into something much more comprehensive. Today it encompasses elements of resource management and denials management as well. This program will review the role of utilization management as it applies to today’s contemporary case management models. Included will be best-practice suggestions for your practice with tips and strategies for streamlining the process and making it as efficient as it can be. Required compliance for utilization management processes will also be addressed. Lastly, there will be a focus on incorporating the role of utilization management with the other roles of case management: resource management, discharge planning, and care coordination.

Why Should You Attend:

With the increased focus on the value of hospital case management, it is imperative that case management professionals understand not only the role of utilization management but how to integrate with other case management roles and functions. Many hospitals are not able to provide a comprehensive didactic orientation program for their new staff. This program will provide that, as it relates to utilization management. This will also be a helpful review and update for seasoned case management staff.

Session Highlights:

Describe the differences between utilization review and utilization management.
Discuss the best practice utilization management strategies to manage an effective case management department.
Identify ways in which a strong utilization management process can reduce payment denials.
Ensure effective physician relationships in the utilization management process.