Utilization management is sometimes called utilization review (UR) where staff is responsible "for the day-to-day provisions of the hospital's utilization plan as required by the Medicare Conditions of Participation."

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Utilization management, often referred to as utilization review, involves the evaluation of healthcare services for their necessity, efficiency, and appropriateness, which includes ensuring compliance with Medicare Conditions of Participation among other regulatory requirements.

Utilization Management Is Sometimes Called Utilization Review (UR) Where Staff