The healthcare management industry has seen a number of dramatic changes for the past 20 years. One of the dramatic changes is the function and role of utilization management, which has evolved as a system to evaluate medical necessity and appropriateness of care related to optimal outcomes.
Utilization Management is a process performed in health care institutions to ensure that patients are hospitalized appropriately for the severity of their illness and the intensity of service (resources) needed for the management of their care.
King Fahd Hospital of the University of the University of Dammam is proud to present a locally developed, practitioner led, intensive program that does meet all your needs regarding utilization management.
This workshop introduces principles of quality improvement and utilization management in health care. Topics include the continuous quality improvement philosophy, including tools, data analysis/application, and related committee functions; utilization management and credentialing, accreditation and regulation.
To understand the major components which form the structure of the utilization review process such as:
o Develop the Utilization Management Plan
o Understand the Screening Criteria
o ISD-A Review System
o Hospital Reason Acute Code List
o Learn the review process:
o Admission Review
o Continued Stay Review
o Discharge Review
o Focused Review