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Categories
- Accreditation Preparation (2)
- NCQA Accreditation (1)
- URAC Accreditation (1)
- General (2)
- Utilization Review (2)
- Webinar (2)
- Accreditation Preparation (2)
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Archives
Do You Have What it Takes to be a UR Nurse?
Utilization reviewers working in hospitals, managed care organizations and other healthcare settings are usually registered nurses (RN) who have strong clinical backgrounds and excellent communication skills, along with substantial experience with medical criteria and guidelines (such as InterQual and Milliman). UR nurses are tasked with "the evaluation of the medical...
Read More Understanding the Utilization Review Process
Utilization Review (UR) is a process implemented by hospitals, insurance companies, and other types of managed care plans. Included in the utilization review process, is the use of "explicit" criteria to determine the medical necessity of the treatment or the health care service appropriate for such a service. This is...
Read More Two Additional Health Literacy Presentations Made Available!
PSN is offering two additional dates and times in December for its popular Health Literacy webinar. The Health Literacy topic covers a required element for URAC accreditation.
Health Literacy is the ability to "obtain, process, and understand basic health information and services needed to make appropriate health decisions."
The webinar will be...
Read More NCQA Accreditation and Certification Surveys: How to Best Prepare
Preparation for an NCQA accreditation or certification survey can be a struggle, but these three action items can dramatically reduce the preparation difficulties and increase an organization's likelihood of success:
Provide adequate resources: The NCQA standards not only address quality improvement, but they also address a number of other areas, too....
Read More Health Literacy Webinar a Success!
If your company provides excellent services and excellent care, why should you care about Health Literacy?
Bottom line: Will patients be able to understand and act upon the instructions that you or your organization provide? The National Academy on Aging Society estimates that "the inability to understand medical direction costs more...
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