5D: (Executive Health Resources) Developing a Leading Utilization Review Plan and Committee
Speakers:
JoAnn Clough, Director of Case Management-UAB Hospitals, Birmingham, Alabama
Carmen Wolf, RN, BSN, Vice President of Advisory Services, Executive Health Resources
Marilyn Palmer,DO, Vice President- Audit, Compliance, Education, Executive Health Resources Newtown Square, PA
Abstract:
The Utilization Review (UR) Committee is an important driver of hospital policy, directly influencing both revenue and compliance. This session will provide a roadmap to creating an interdisciplinary UR Committee that plays a central role in medical policy creation and serves as a vital interface between the hospital and its medical staff. This session will also focus on the vital role case management plays on the UR Committee and within the UR process.
Learning Objectives:
1. Explain the importance of the UR Committee
2. Evaluate the efficacy of the UR committee using key metrics
3. Develop a plan to structure the Committee to serve as a vehicle to support compliance
JoAnn Clough, Director of Case Management-UAB Hospitals, Birmingham, Alabama
Carmen Wolf, RN, BSN, Vice President of Advisory Services, Executive Health Resources
Marilyn Palmer,DO, Vice President- Audit, Compliance, Education, Executive Health Resources Newtown Square, PA
Abstract:
The Utilization Review (UR) Committee is an important driver of hospital policy, directly influencing both revenue and compliance. This session will provide a roadmap to creating an interdisciplinary UR Committee that plays a central role in medical policy creation and serves as a vital interface between the hospital and its medical staff. This session will also focus on the vital role case management plays on the UR Committee and within the UR process.
Learning Objectives:
1. Explain the importance of the UR Committee
2. Evaluate the efficacy of the UR committee using key metrics
3. Develop a plan to structure the Committee to serve as a vehicle to support compliance
