Catalog

Utilization Management Peer Reviewer Training
Online
Added:

The course will present the principles and procedures of Utilization Review and Utilization Management standards as required by URAC's Health Utilization Management Accreditation and American Accreditation Health Care Commission under the Health Utilization Management Standards.
This online course will provide a detailed explanation of how health care professionals can keep medical decisions in the hands of qualified practitioners as peer reviewers.
At the conclusion of this activity, attendees should be able to:
Evaluate utilization review cases using the appropriate review process
Interpret utilization review terminology and concepts
Compare and contrast differences between the various types and levels of utilization review
Write clear and concise utilization review determination reports
Integrate clinical and medical reference material to create an appropriate determination rationale
Recognize applicable standards, as applied to utilization review activities
Apply utilization review process to improve personal clinical practice
Recognize the difference between internal and external reviews
Describe the external review process
Faculty includes:
Linda G. Sheff, MBA
About the Authors
Members of the CME Committee, Planners, and Faculty have disclosed to ABQAURP any relevant financial relationships. No relevant financial relationships or conflicts of interest exist in regard to the content of this online activity.
ACCREDITATION & CREDIT
The American Board of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
ABQAURP designates this enduring material for a maximum of 5.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
The American Board of Quality Assurance and Utilization Review Physicians (ABQAURP) is an approved provider with the Florida Board of Nursing to provide continuing education for nurses. ABQAURP designates this activity for 5.0 contact hours through the Florida Board of Nursing. Provider # 50-94.
This program is approved for Category 2 credit by the American Osteopathic Association.
This activity is valid from March 16, 2022, through March 14, 2025. (Previously valid: March 16, 2019 through March 15, 2022 and reviewed February-March 2022.)
Pricing:

Diplomate $170.00

Professional Member $190.00

Non-Member $230.00
Credits awarded per Session. See individual Sessions for further details.
Credits awarded
Name
Sub type
Value
Certificate awarded

About this item

The course will present the principles and procedures of Utilization Review and Utilization Management standards as required by URAC's Health Utilization Management Accreditation and American Accreditation Health Care Commission under the Health Utilization Management Standards.

This online course will provide a detailed explanation of how health care professionals can keep medical decisions in the hands of qualified practitioners as peer reviewers.

At the conclusion of this activity, attendees should be able to:
  • Evaluate utilization review cases using the appropriate review process
  • Interpret utilization review terminology and concepts
  • Compare and contrast differences between the various types and levels of utilization review
  • Write clear and concise utilization review determination reports
  • Integrate clinical and medical reference material to create an appropriate determination rationale
  • Recognize applicable standards, as applied to utilization review activities
  • Apply utilization review process to improve personal clinical practice
  • Recognize the difference between internal and external reviews
  • Describe the external review process

Faculty includes:
Linda G. Sheff, MBA

About the Authors
Members of the CME Committee, Planners, and Faculty have disclosed to ABQAURP any relevant financial relationships. No relevant financial relationships or conflicts of interest exist in regard to the content of this online activity.

ACCREDITATION & CREDIT
The American Board of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

ABQAURP designates this enduring material for a maximum of 5.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

The American Board of Quality Assurance and Utilization Review Physicians (ABQAURP) is an approved provider with the Florida Board of Nursing to provide continuing education for nurses. ABQAURP designates this activity for 5.0 contact hours through the Florida Board of Nursing. Provider # 50-94.

This program is approved for Category 2 credit by the American Osteopathic Association.

This activity is valid from March 16, 2022, through March 14, 2025. (Previously valid: March 16, 2019 through March 15, 2022 and reviewed February-March 2022.)

Pricing:
Diplomate $170.00
Professional Member $190.00
Non-Member $230.00

Course/Activity Information

This course contains some updated material, you may retake this course, claim continuing education credits, and receive an updated certificate, if you have taken in the past.

This course is intended for Physicians of all specialties, Nurses, and Other Health Care Professionals with appropriate CME / CE credit offered for each profession.
All participants must achieve a final assessment score of at least seventy percent (70%) for recertification and continuing education credits. You have 60 days to complete the course after ordering.

This activity is valid from March 16, 2022 through March 15, 2025.

About The Authors
Members of the CME Committee, Planners, and Faculty have disclosed to ABQAURP any relevant financial relationships. No relevant financial relationships or conflicts of interest exist in regard to the content of this online activity.

Editorial Staff: The faculty and program planners are employees of Physicians' Review Network and have no conflicts of interest in regard to the content of this activity.

Linda G. Sheff, MBA, CHCQM
Linda G. Sheff, M.B.A. is the former President and Chief Executive Officer of Physicians' Review Network, Inc. (PRN). Ms. Sheff received a Bachelor of Sciences and a Master of Business Administration from the State University of New York at Buffalo. She is a fellow of the American Board of Quality Assurance and Utilization Review Physicians. Ms. Sheff has an extensive background in health care, medical reviews, and many years of managerial experience in laboratory services, information technology, and hospital administration prior to concentrating on the utilization review industry in 1989.

Other information

Additional Charges May Apply

Ratings and reviews

Close