Course Provider
Learning Objectives
Articulate comprehensive UR practices tailored to Medicare, Medicaid, VA, and commercial insurances.
Describe specific utilization review requirements for specialty areas such as NICU, behavioral health, and elective surgical services.
Identify the key phases of utilization review and outline strategies to strengthen collaboration with Physician Advisors.
Evaluate denial types & assess how utilization review processes influence clinical, operational, and financial performance.