MCG Health, part of the Hearst Health network and the industry's source of truth for trusted clinical guidance, announces ...

The utilization review process is designed to help hospitals determine the appropriate level of care and care setting for patients based on medical necessity. While this process is an expense for ...

Concurrent review is a utilization review process that occurs while a patient is actively receiving treatment, such as during a hospital stay. It evaluates the medical necessity and appropriateness of ...

California is among a handful of states that seeks to regulate the use of artificial intelligence (“AI”) in connection with utilization review in the managed care space. SB 1120, sponsored by the ...

The following information was released by the Federation of American Scientists:. Text by Y. Tony Yang. A wheelchair user with complex care needs submits a prior-authorization request that her ...

PLEASANTON, Calif.--(BUSINESS WIRE)--State Fund announced today that it will soon launch a revolutionary utilization review (UR) technology called UR Connected. The system will dramatically speed up ...

The administrative burden of utilization review processes like prior authorizations and concurrent review has long been a thorn in the side of healthcare providers. While prior authorizations have ...

Medicaid managed care utilization review data for mental health services were analyzed for the calendar years 2017 and 2018. These data indicate low rates of utilization review denials for both ...

With the rapid development of artificial intelligence (AI), state legislatures have been attempting to keep up with the technological advancing surge. Most recently, Texas enacted Senate Bill (SB) 815 ...

If you would like to learn more about the IAEA’s work, sign up for our weekly updates containing our most important news, multimedia and more. An international team of experts completed the first IAEA ...

Kanika Kapur is an associate economist at RAND in Santa Monica, California. Carole Roan Gresenz is an economist at RAND in Arlington, Virginia. David Studdert is an assistant professor of law and ...