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Health Care > Utilization Review, Delegated

The following information is about Utilization Review, Delegated.

Utilization Review, Delegated Defined

An entity external to the hospital under contract to the payer to review services provided a specific population contracts to use hospital personnel to conduct the review process. The norms, criteria and standards may be those adopted by the hospital medical staff or the external agency may require that its protocols be used. The hospital must report its patient-specific findings to the entity; it may also be required to summarize overall findings from its internal UR process.

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