A recent opinion from the Commonwealth Court of Pennsylvania has changed the rules for Utilization Review and thrown open the doors to a new class of litigants. In Keystone Rx, LLC v. AmeriHealth (Fee ...
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 ...
The utilization review process, in which an employer may challenge the reasonableness or necessity of the medical treatment of an injured employee, was at issue in County of Allegheny (John J. Kane ...
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