Name: Utilization Review: Information on External Review Organizations: Hrd-93-22fs (en Inglés)
SKU: 59934395
Price: 81261.00 COP
Availability: InStock
Author: U. S. Government Accountability Office ( ; U. S. Government Accountability Office (
ISBN: 9781289069841

portada Utilization Review: Information on External Review Organizations: Hrd-93-22fs (en Inglés)

Utilization Review: Information on External Review Organizations: Hrd-93-22fs (en Inglés)

Formato

Libro Físico

Editorial

Bibliogov

Autor

U. S. Government Accountability Office ( ; U. S. Government Accountability Office (

Idioma

Inglés

N° páginas

104

Encuadernación

Tapa Blanda

Dimensiones

24.6x18.9x0.6 cm

Peso

0.20 kg.

ISBN13

9781289069841

Categorías

Política y gobierno

Utilization Review: Information on External Review Organizations: Hrd-93-22fs (en Inglés)

U. S. Government Accountability Office ( ; U. S. Government Accountability Office ( (Autor) · Bibliogov · Tapa Blanda

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Reseña del libro "Utilization Review: Information on External Review Organizations: Hrd-93-22fs (en Inglés)"

Pursuant to a congressional request, GAO reviewed utilization review organizations (URO), focusing on: (1) the size and ownership of URO; (2) the professional qualifications of staff involved in utilization review decisions; (3) the complexity of decisions made by various staff; (4) appeal procedures; (5) clinical review criteria used by URO; and (6) quality assurance procedures implemented to ensure adherence to company directives. GAO found that: (1) physicians are usually employed by URO on a part-time basis or as consultants/advisors; (2) registered nurses are heavily involved in first-level review decisions, but physicians become more involved during the second-level review and appeal process; (3) URO generally used commercially developed review criteria when making recommendations; (4) most URO have established appeal procedures; (5) of the few utilization decisions that are appealed, many are successful; (6) URO have implemented quality assurance procedures to ensure adherence to company directives; (7) in 1990, a commission was established to develop quality assurance standards for URO and to accredit organizations that seek this distinction; (8) many URO set minimum qualifications and education levels for clinical and nonclinical staff; and (9) URO activities included prehospital admission certification review, concurrent reviews, second surgical opinions, and case management.