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Annual Report for Utilization Review Organizations State of Louisiana Reporting Period January 1, 2015, to December 31, 2015James J. Donelson Commissioner of Insurance Annual Report 01/21/16 asj2015

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How to fill out utilization review organizations

01

Gather all necessary medical documentation and information related to the patient

02

Review the patient's medical history and current medical condition

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Determine the appropriateness of the requested medical treatment or services

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Evaluate the medical necessity and potential risks of the requested treatment or services

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Consider the availability of alternative treatment options and assess their efficacy

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Verify the patient's insurance coverage and policy guidelines

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Submit the utilization review request with all supporting documents to the appropriate utilization review organization

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Await the review and decision from the utilization review organization

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Communicate the utilization review organization's decision to the relevant healthcare providers and the patient

Who needs utilization review organizations?

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Insurance companies

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Patients

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