Who reviews the medical care you use

Excerpt From CHAPTER 8 of the Consumer Protection Healthcare Handbook

”WHAT IS UTILIZATION REVIEW?

Ah, now we are getting into some important INSIDE information.

This is an organization that works for the payers (HMO, Private Medical Insurance Plans, Medicare, Medicaid) that reviews your medical care to see if the care YOUR doctor requested is necessary.

There are many private companies who contract with your HMO, Insurance Company, Medicare or Medicaid to do this for them. Sometimes the health care plan (payer) itself does it.

If it is a private company who does this, they frequently promise to the health care plan that they can save them all sorts of money. The health care plan wants to hire the utilization company who they think may save them the most money.

To see more get the handbook at www.dranonymous.com