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Status Medical Management Modesto CA 95352 Utilization Review Plan June 1, 2018UR Plan Revised September 20182Table of Contents UTILIZATION REVIEW DEFINITIONS3INTRODUCTION6Mission Statement6PROGRAM
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How to fill out continuing care utilization review

01
Start by gathering all the necessary information about the patient and their medical history.
02
Review the patient's current medical condition and treatment plan.
03
Assess the patient's ongoing healthcare needs and determine if continuing care is necessary.
04
Complete the continuing care utilization review form, providing accurate and detailed information.
05
Include supporting documentation such as medical records, test results, and physician recommendations.
06
Submit the filled-out form and supporting documents to the appropriate department or organization.
07
Follow up with any additional information or clarification as needed.
08
Review the decision made based on the utilization review and take appropriate action.
09
Communicate the decision to the patient and relevant healthcare providers.
10
Keep a record of the utilization review process for documentation and future reference.

Who needs continuing care utilization review?

01
Continuing care utilization review is typically needed for patients who require ongoing medical care, such as those with chronic illnesses, long-term disabilities, or complex medical conditions.
02
It is also necessary for patients who are seeking reimbursement for extended healthcare services or those who need to justify the need for continuing care to insurance providers or government agencies.
03
Healthcare facilities and organizations may also conduct continuing care utilization reviews to ensure appropriate allocation of resources and to monitor the quality and effectiveness of care.
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Continuing care utilization review is a process used by insurance companies to evaluate the necessity and efficiency of ongoing care for a patient.
Healthcare providers or insurance companies are typically responsible for filing continuing care utilization reviews.
Continuing care utilization reviews can be completed by submitting patient information, treatment plans, and justification for continued care to the insurance company.
The purpose of continuing care utilization review is to ensure that ongoing medical treatment is necessary and cost-effective for the patient.
Information such as patient medical history, current treatment plan, and expected outcomes must be included in a continuing care utilization review.
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