Utilization Management

Question 1

Concurrent reviews - daily

Have it add your name to document signing for concurrent reviews (IT function)

Answer 1

**Look at document signing folder frequently to check for
client signatures or
documentation of review on treatment plans concurrent reviews on 100% of the reviews completed

** complete review of concurrent reviews for 20% of cases

Question 2

For CFS - Choose 2 reviews per staff member for Team Leader Clinical Review

Answer 2

track it forms are received within 30 days

Consult for updates on UR process

Question 3

All UR forms are mandated to retain for how many years?

Answer 3

For a period of five years.

Question 4

Service search report

Answer 4

This report is run weekly to pull files for intake review. Send reviews to team leaders, track if reviews are received within 30 days

1 per month per clinician in CFS
1 every other month per clinician in AOP/IOP
100% intake review for new staff within the first six months