*  Drug Utilization Review
Federal regulations at 42 C.F.R. § 456.703 - 456.725 require that Medicaid pharmacy programs establish and maintain a Drug Utilization Review (DUR) program that helps to ensure appropriate drug utilization by conducting prospective and retrospective drug utilization review, and maintaining an educational program. These regulations also require that state Medicaid pharmacy programs establish and maintain a Drug Utilization Review Board (DUR Board). More information about the DUR Board, including membership lists, meeting schedules, and meeting minutes can be found on the DUR Board Web page. ...
*  Medicare Boot Camp®-Utilization Review Version
... is an intensive two-day course focusing on the Medicare regulatory requirements for patient status and the role of the utilization review (UR) committee.
*  Clinical Services | Drug Utilization Reviews | Pharmacy Data Management
Available programs include concurrent drug utilization reviews, retrospective drug utilization reviews, polypharmacy monitoring and alerts, fraud, misuse and abuse.
*  Utilization Review Nurse Jobs in Memphis, TN | Glassdoor
Search Utilization Review Nurse jobs in Memphis, TN with company ratings & salaries. 274 open jobs for Utilization Review Nurse in Memphis.
*  Patent US6324516 - System and apparatus for utilization review of medical claims - Google Patents
A medical cost containment system for ensuring that the anticipated cost savings from utilization review (UR) agreements are actually realized. The UR agreements are essentially contractual agreements that specify the type and quantity of medical treatments relating to a specific claim resulting from a specific injury. Each UR agreement comprises a claim number, a procedure code describing the particular medical service authorized, and some indication as to dates or quantity of service authorized. All of the UR agreements are stored in a UR database. When a medical bill is received by the insurance company, the bill is entered in to the computer. The cost containment system searches all UR agreements in the UR database which have the same claim number as the claim number on the bill. For each item in the medical bill, the system finds the UR agreement which most closely matches the procedure code in the line item and various other criteria, such as the dates of treatment. ...
*  The Weinmann Report - politicsofhealthcare.com: UTILIZATION REVIEW: HYPOCRISY IN VELVET GLOVES
UTILIZATION REVIEW'S STANDARD OF PRACTICE is woefully short on both ethics and knowledgeable practice. In the case at hand the PTP is knowledgeable re the standards of care re managing pain. The UR doctor's response appeared knowledgeable from textbook information but was seriously flawed in its application to the now denied patient. The denial was rammed through without a good faith effort to confer with the PTP. Two UR doctors made phone calls at unreasonable hours and then claimed to have left messages. The PTP doubts the latter assertion. So does this author. Our experience is that UR is repeatedly conducted in bad faith and to the best of our belief with the knowledge and connivance of the insurance companies. ...
*  Guidelines for Conducting Drug Resistant TB Drug Utilization Reviews: Kenya Field Test | Management Sciences for Health
Successful treatment of tuberculosis (TB) is one of the key indicators of a TB Control Program's performance and essential to containing the emergence of anti-TB drug resistance. Multi-drug resistant TB (MDR-TB) treatment requires medicines that are expensive, involve longer treatment regimens, are toxic, and can cause patients to have severe side effects. However, international guidelines and national regulations for the diagnosis and treatment of MDR-TB seldom provide unbiased sources of information on monitoring drug use, side effects, or indicators to assess the quality of prescribing according to the regulations.. For proper and impartial monitoring of rational drug use, drug utilization reviews (DUR) are used to identify common problems such as inappropriate product selection, incorrect dosing, avoidable adverse drug reactions, and errors in drug dispensing and administration (see Managing Drug Supply 3: Chapter 30, PDF). Under a prior MSH project, an ...
*  Utilization Review Physician Telecommute Board Certified NY Licensed Neurosurgeon Newark, NJ PRN jobs, Employment in Newark, NJ.
Utilization Review Physician Telecommute Board Certified NY Licensed Neurosurgeon Newark, NJ PRN jobs in your area. Apply now to join Concentra.
*  Certified Professional Utilization Review (CPUR) Wages, Hourly Wage Rate | PayScale
Certified Professional Utilization Review (CPUR) - Hourly Rate - Get a free salary comparison based on job title, skills, experience and education. Accurate, reliable salary and compensation comparisons for United States
*  Drug Utilization Review Board (DURB) Meeting
The Drug Utilization Review Board (DURB) will meet on February 16 from 9:00 a.m. to 4:00 p.m., Meeting Room 6, Empire State Plaza, Concourse Level, Albany.. For further information contact Anthony Merola at (518) 486-3209 or e-mail dur@health.ny.gov (Please reference DURB Agenda for February 16, 2017).. ...
*  What is drug utilization review? definition and meaning - BusinessDictionary.com
Definition of drug utilization review: A process of appraising and reconsidering the usage of drugs to determine the effectiveness of drug treatment.
*  How Do I Become a Utilization Review Nurse? (with pictures)
To become a utilization review nurse, you will generally need to get a degree in nursing, get a valid nursing license, and then...
*  The Weinmann Report - politicsofhealthcare.com: IN-STATE V. OUT-OF-STATE UTILIZATION AND INDEPENDENT MEDICAL REVIEW
As matters stand now traditional Utilization Review does not need to be done by doctors who are licensed in California and are therefore responsible to our state medical board. Insurance companies can scour the country in search of malleable and cooperative doctors who will deny care on a myriad of technicalities no matter how harmful these denials of care are to injured workers. This injustice cannot happen in Texas. In Texas if California doctors want to do utilization review the doctors must be licensed in Texas. Since each state's medical board's jurisdiction is limited to its own state, many of the doctors doing utilization review or independent medical review in California may not come under the medical board jurisdiction of any state at all for their UR or IMR work in California. This largesse is estimated to cost California $10,000,000 annually -- an unwise choice for a state with ...
*  American Urological Association - Payer Utilization Review
Almost all payers are scrutinizing the utilization of services in order to reduce costs. There are several documents that can be helpful in understanding the types of services drawing the most attention.
*  The Weinmann Report - politicsofhealthcare.com: UTILIZATION REVIEW (UR) BY NON-CALIFORNIA LICENSED DOCTORS
The crux of the issue in past years was precisely this point. The insurance companies skillfully and successfully opposed requiring California state licensure for UR doctors. Three bills so stating have passed the California legislature: AB 2969 (Lieber), AB 933 (Fong), and AB 584 (Fong). The first two were vetoed by Governor Schwarzenegger, no surprise there since his mission was to protect the insurance companies. The last one was vetoed by Governor Brown, much to the astonishment of many who did not think he'd bend to insurance company wishes. However, lobbying credit has to go to the insurance companies -- they succeeded in convincing two different and supposedly opposed administrations to veto nearly identical bills that would have assisted injured workers' access to care ...
*  The Weinmann Report - politicsofhealthcare.com: SB 863 ALERT: WATCH FOR ASSAULT ON NON-CALIFORNIA LICENSED UTILIZATION REVIEW...
Writing in Neurology Today, Vol. 3 (8), August 2003, Dawn Antoline writes "Robert L. Weinmann, MD, has never been one to shy away from controversy. Whether he is writing muckraking editorials about HMOs that deny physician claims or ... billing practices ... he has committed himself to a life of activism. At the heart of his advocacy is a passionate regard for his patients -- and the ability of physicians to provide unfettered optimal care ...
*  NHS Greater East Midlands Utilisation Review Programme Elects to Use Medworxx Patient Flow
Medworxx Patient Flow client community welcomes a new NHS client - Greater East Midlands Commissioning Support Unit, Service Transformation&rsqu
*  The Weinmann Report - politicsofhealthcare.com: MALPRACTICE BY UTILIZATION REVIEW?
In summary, although we believe we know more, the facts as stated above can safely be stated with reasonable medical probability. In previous op-eds, see also my reprints in workcompcentral, we've pointed out that Dr. Frantozzi as president of the MBC submitted a letter stating that UR was part of the practice of medicine and required a California medical license -- in this case, the offending UR doctor does in fact have a California medical license which is why the MBC retains jurisdiction in this case. In other cases where the UR doctor does not have a California medical license, there would be no sense in even submitting this complaint to the MBC. Malpractice litigation would be the only choice. In this case, it appears that both options are open. We'll follow up when we know more, Stay tuned. ...
*  Workers' comp utilization review - highlights from the First Annual Survey - Managed Care MattersManaged Care Matters
Among those respondents using vendors for some or all of their UR work, the average vendor has been in place for five years - however most don't see much of a barrier to switching vendors. In fact, two-thirds of both groups believe that it is neutral to very easy to make a UM/UR vendor switch. Further yet, approximately a quarter of both the FL and the EXs stated that it would be not hard or very easy to make the switch.. There's much more detail to the Survey; we'll be presenting results, and you can get a copy of the Survey Report, at the NWCD Conference in Las Vegas next month. The presentation and Q&A will be held at CID's booth; I'll be posting the schedule next week.. ...
*  5997589960: Phoenix, AZ, 54 Yrs Old, 5'5" Tall, White Woman Neonatal Intensive Care RN- Case Manager, Utilization Review
eharmony Member #5997589960 is a 54 Year Old White Christian woman in Phoenix, AZ. She has never married and has no children. Review your matches for free now!
*  Utilization Review Manager Salaries in Garden City, NY | Indeed.com
Please note that all salary figures are approximations based upon third party submissions to Indeed. These figures are given to the Indeed users for the purpose of generalized comparison only. Minimum wage may differ by jurisdiction and you should consult the employer for actual salary figures ...
*  Health Plan Services
Participating health plans agree to limit data to HIPAA-permitted uses for payment and health care operations as defined by law. Permitted uses include billing, claims management, utilization review, identifying members for care management and improving the accuracy of HEDIS/STARs measures, plus more.. Contact Peg Eichner, HIE Project Manager, for more information on Health Plan Services at peichner@ohiponline.org ...
*  How Payers and Oncologists Really Feel About Oncology Pathways
Ultimately, for clinical pathways to be effective, the oncologists have to be using them. With that in mind, health plans are devising a number of ways to incentivize pathway use. According to payers surveyed, higher drug reimbursements and reduced administrative requirements (eg, prior authorization) are the most frequently applied incentives for physicians who adhere to pathways. Less commonly used incentives are expedited utilization reviews and reimbursement processing, in-network requirements, and preferred provider status within network. According to the MCOI, getting doctors on pathway may not be too difficult. The oncologist respondents found pathways influential and were in favor of their use. Of 60 oncologists surveyed, just less than half said they plan on adopting pathways within the next 2 years ...
*  Building a better Rift Valley fever vaccine | EurekAlert! Science News
Researchers have significantly improved an existing experimental vaccine for Rift Valley fever virus, making possible the development of a more effective defense against the dangerous mosquito-borne pathogen.