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  2. Utilization categories - Wikipedia

    en.wikipedia.org/wiki/Utilization_categories

    Usually utilization category is mentioned in most of the switch gear, with the above contactor stating to be used under AC1 - resistive load & AC3 for motor usage. In electrical engineering utilization categories are defined by IEC standards [1] and indicate the type of electrical load and duty cycle of the loads to ease selection of contactors ...

  3. National coverage determination - Wikipedia

    en.wikipedia.org/wiki/National_coverage...

    It is a form of utilization management and forms a medical guideline on treatment. Medicare coverage is limited to items and services that are considered "reasonable and necessary" for the diagnosis or treatment of an illness or injury (and within the scope of a Medicare benefit category). [2]

  4. Utilization management - Wikipedia

    en.wikipedia.org/wiki/Utilization_management

    Utilization management is "a set of techniques used by or on behalf of purchasers of health care benefits to manage health care costs by influencing patient care decision-making through case-by-case assessments of the appropriateness of care prior to its provision," as defined by the Institute of Medicine [1] Committee on Utilization Management by Third Parties (1989; IOM is now the National ...

  5. Managed care - Wikipedia

    en.wikipedia.org/wiki/Managed_care

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

  6. Unnecessary health care - Wikipedia

    en.wikipedia.org/wiki/Unnecessary_health_care

    Unnecessary health care (overutilization, overuse, or overtreatment) is health care provided with a higher volume or cost than is appropriate. [1] In the United States, where health care costs are the highest as a percentage of GDP, overuse was the predominant factor in its expense, accounting for about a third of its health care spending ($750 billion out of $2.6 trillion) in 2012.

  7. The pros and cons of Medicare Advantage: Should you ... - AOL

    www.aol.com/finance/medicare-advantage-pros-cons...

    Medicare Advantage and Medicare Prescription Drug Programs to Remain Stable in 2024, U.S. Centers for Medicare and Medicaid Services. Accessed September 6, 2024. Accessed September 6, 2024.

  8. Healthcare Cost and Utilization Project - Wikipedia

    en.wikipedia.org/wiki/Healthcare_Cost_and...

    The Healthcare Cost and Utilization Project (HCUP, pronounced "H-Cup") is a family of healthcare databases and related software tools and products from the United States that is developed through a Federal-State-Industry partnership and sponsored by the Agency for Healthcare Research and Quality (AHRQ).

  9. ‘No one should have to be fighting cancer and insurance at ...

    www.aol.com/no-one-fighting-cancer-insurance...

    The majority of insured US adults had at least one health insurance problem – including denial of claims – in the span of a year, according to a survey released in June 2023 by KFF, a ...