Set of processes used to determine the appropriateness of medical services provided during specific episodes of care.

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22-07-2022
Medicine

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Set of processes used to determine the appropriateness of medical services provided during specific episodes of care.

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tutorconsortium31 tutorconsortium31 · Answer 1 · 2022-07-29T09:30:47+02:00

Utilization Management (UM)

composed of a set of processes used to determine the appropriateness of medical services provided during specific episodes of care. Whether the services are determined to be appropriate is based on the patient's diagnosis, the site of care, the length of stay (LOS), and other clinical factors.

What is Utilization Management (UM) ?

Utilization management (UM) is the evaluation of the medical necessity, appropriateness, and efficiency of the use of health care services, procedures, and facilities

The goal is to ensure the delivery of efficient and effective health care, to reduce the misuse of inpatient services, and to promote high quality and safe patient care during the inpatient component of the care.

Learn more about Utilization Management (UM) here:

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