Health systems and health insurance plans spend enormous sums of money battling over how to be paid fairly — and these battles have only intensified with the growth of Medicare Advantage plans, which ...

8 Managed Care Contract Questions Regarding Utilization and Management Naya Kehayes, managing principal and CEO of Eveia Health Consulting and Management, recommends hospitals and other providers ask ...

Concurrent review is a utilization review process that occurs while a patient is actively receiving treatment, such as during a hospital stay. It evaluates the medical necessity and appropriateness of ...

Colorado House Bill 25-1002, effective January 1, 2026, amends Colorado Revised Statutes § 10-16-104(5.5) to require health benefit plans to use nationally recognized, not-for-profit clinical criteria ...

Users will be exposed to a more efficient platform which will allow for increased productivity while being able to rapidly review medical bill history through simple navigation. ManageWare's ...

The American Board of Quality Assurance and Utilization Review Physicians (ABQAURP) is pleased to present its 48th Annual Conference on September 11-12, 2025, in Clearwater Beach, FL. Attendees save ...

PALM BEACH GARDENS, Fla.--(BUSINESS WIRE)--Dane Street is proud to announce its URAC accreditation for Independent Review Organization (IRO) and Workers’ Compensation Utilization Management (WCUM) ...