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2. Utilization management - Wikipedia

   en.wikipedia.org/wiki/Utilization_management

   Utilization management (UM) or utilization review is the use of managed care techniques such as prior authorization that allow payers, particularly health insurance companies, to manage the cost of health care benefits by assessing its medical appropriateness before it is provided, by using evidence-based criteria or guidelines.

3. Drug utilization review - Wikipedia

   en.wikipedia.org/wiki/Drug_Utilization_Review

   There are some issues addressed by this review: drug abuse clinically, alteration of drug dosage, drug–drug interaction, and drug-disease interaction. [1] Measure and record the blood pressure for next therapy. This review seems the best review over all three reviews because it is the closest option of the ideal. [11]

4. Independent medical review - Wikipedia

   en.wikipedia.org/wiki/Independent_medical_review

   An independent medical review (IMR) is the process where physicians review medical cases in order to provide claims determinations for health insurance payers, workers compensation insurance payers or disability insurance payers. Peer review also is used in order to define the review of sentinel events in a hospital environment for quality ...

5. Health insurance premiums in America could rise to ‘highest ...

   www.aol.com/finance/health-insurance-premiums...

   Going without health insurance could leave you on the hook for catastrophically large bills. But this year, you may end up paying more for health coverage due to circumstances outside your control ...

6. Affordable Care Act Health Insurance Rate Review Program

   en.wikipedia.org/wiki/Affordable_Care_Act_Health...

   The Affordable Care Act (ACA) established the health insurance rate review program in order to protect consumers from unreasonable rate increases. [1] Through this program, proposed premium increases in the small group and individual markets that are above a threshold amount (ten percent or more, as of February 2014) are reviewed by states or the federal government to determine whether the ...

7. Participation in mental health care in low-income households ...

   www.aol.com/lifestyle/participation-mental...

   While pre-insurance therapy fees can be cost prohibitive, the 2008 Mental Health Parity and Addiction Equity Act requires health insurance plans to provide more equitable coverage for mental ...