The Phelps Memorial Health Center Utilization Review (UR) Department is
a highly motivated professional service to assure high quality of
patient care, effective and efficient utilization of hospital services
to all patients.
The PMHC review team consists of two experienced registered nurses. They
perform admission screenings and then notify insurance companies, and
HMO's for precertification when necessary. They also perform continued
stay/concurrent review and retrospective reviews if needed. They analyze
the medical record to assure that the patient receives the quality and
quantity of services at the appropriate time in the appropriate setting
to be consistent with their medical care needs.
UR also reviews pertinent medical records for core measures for acute
myocardial infarction, congestive heart failure, pneumonia and surgical
infection prevention to be sent to Medicare for review. Core measures
are standards set by Medicare and Joint Commission to assure the right
care for every person every time.
Departments
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