Qual Mgnt and Integrated Sys OL
Description
Instructions
Refer to text chapter 11, Exercise 11.1
Refer to text chapter 12, Exercise 12.1
What Utilization Management (UM) practices do your health insurance company follow to control costs and ensure the provision of medically necessary services? This information may be available in your insurance benefits booklet or on your health plan’s website. If you do not have health insurance, go to the website of any major health insurance company, and list the practices this company follows to control costs and to ensure the provision of medically necessary services. Select two practices and explain how each practice helps to control costs and ensure UM practice.
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