HUM v. 6.0 HUM Clinical Review (1, 5, 10-29)
The following pages provide a basic summary, management tips, and accreditation advice for the health utilization management clinical review standards in URAC's Health Utilization Management Module, v. 6.0.
- HUM - 1 - Review Criteria Requirements
- HUM - 5 - On-Site Review Requirements
- HUM - 10 - Initial Clinical Reviewer Qualifications
- HUM - 11 - Initial Clinical Reviewer Resources
- HUM - 12 - Initial Clinical Reviewer Non-Certifications
- HUM - 13 - Peer Clinical Review Cases
- HUM - 14 - Peer Clinical Reviewer Qualifications
- HUM - 15 - Peer-to-Peer Conversation Availability
- HUM - 16 - Peer-to-Peer Conversation Alternate
- HUM - 17 - Prospective Review Time Frames
- HUM - 18 - Retrospective Review Time Frames
- HUM - 19 - Concurrent Review Time Frames
- HUM - 20 - Certification Decision Notice and Tracking
- HUM - 21 - Continued Certfication Decision Requirements
- HUM - 22 - Written Notice of Non-Certification Decisions and Rationale
- HUM - 23 - Clinical Rationale for Non-Certification Requirements
- HUM - 24 - Reversal of Certification Determinations
- HUM - 25 - Frequency of Continued Reviews
- HUM - 26 - Scope of Review Information
- HUM - 27 - Prospective and Concurrent Review Determinations
- HUM - 28 - Retrospective Review Determinations
- HUM - 29 - Lack of Information Policy and Procedures
- End of HUM v. 6.0 HUM Clinical Review (1, 5, 10-29)
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HUM v. 6.0 HUM Clinical Review (1, 5, 10-29)
- HUM - 1 - Review Criteria Requirements
- HUM - 5 - On-Site Review Requirements
- HUM - 10 - Initial Clinical Reviewer Qualifications
- HUM - 11 - Initial Clinical Reviewer Resources
- HUM - 12 - Initial Clinical Reviewer Non-Certifications
- HUM - 13 - Peer Clinical Review Cases
- HUM - 14 - Peer Clinical Reviewer Qualifications
- HUM - 15 - Peer-to-Peer Conversation Availability
- HUM - 16 - Peer-to-Peer Conversation Alternate
- HUM - 17 - Prospective Review Time Frames
- HUM - 18 - Retrospective Review Time Frames
- HUM - 19 - Concurrent Review Time Frames
- HUM - 20 - Certification Decision Notice and Tracking
- HUM - 21 - Continued Certfication Decision Requirements
- HUM - 22 - Written Notice of Non-Certification Decisions and Rationale
- HUM - 23 - Clinical Rationale for Non-Certification Requirements
- HUM - 24 - Reversal of Certification Determinations
- HUM - 25 - Frequency of Continued Reviews
- HUM - 26 - Scope of Review Information
- HUM - 27 - Prospective and Concurrent Review Determinations
- HUM - 28 - Retrospective Review Determinations
- HUM - 29 - Lack of Information Policy and Procedures
- End of HUM v. 6.0 HUM Clinical Review (1, 5, 10-29)
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