HC 433 Herzing University Utilization Review Process Discussion
HC 433 Herzing University Utilization Review Process Discussion
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Discussion: Unit 3, Due Friday by 11:59 pm
Utilization Review
INSTRUCTIONS:
Utilization management and review is a process to determine if health care services are being used appropriately on a patient. Often, this process is completed by a group, in-house, that may not have the hands-on patient experience or clinical knowledge that physicians have. The result of the review may provide unrealistic expectations for the clinician.
ORDER NOW FOR CUSTOMIZED SOLUTION PAPERS
Instructions:
- Assume the role of a manager and reflect on the utilization review process.
- Do you think utilization is a positive process? Explain why or why not in depth, utilizing external resources as appropriate.
- What changes would you recommend for this process?
Please be sure to validate your opinions and ideas with citations and references in APA format. This topic is valued at 20 points. Please review post and response expectations. Please review the rubric to ensure that your response meets criteria.
Estimated time to complete: 2 hours
Peer Response: Unit 3, Due Sunday by 11:59 pm CT
Utilization Review
INSTRUCTIONS:
Read the initial posts made by classmates. Respond to a minimum of 2 peers with the following:
- Do you consider the changes proposed applicable to the utilization review process?
- Explain how the changes would improve the process.
- If the changes would not improve the process, provide additional suggestions.
- Often times, the manager will be called upon to make a final decision between the physician and the utilization review board. What steps can be taken to ensure that the most appropriate decision is made?
Please be sure to validate your opinions and ideas with citations and references in APA format. Please review post and response expectations. Please review the rubric to ensure that your response meets criteria
Estimated time to complete: 2 hours