Utilization management was the first role applied in acute care case management models. It was first known of as utilization review but has evolved into something much more comprehensive than that. Today it encompasses elements of resource management and denials management as well. Physicians, both the practicing physician and the physician advisor are often left out of this important process and must be included in any contemporary case management utilization management model.
Our Relias Certified CMS Professional Program will guide attendees through the entire CMS Hospital CoP manual and highlight major changes that impact hospitals. The program is divided into five parts with each part accompanied by an exam. After completing the program, attendees will receive a certification that they are a Certified CMS Professional (CCMSP).
Part III of the series will cover nursing and pharmaceutical services, including infection control, antibiotic stewardship program, and safe opioid use.