Practice Guidelines, Managed Care, and Utilization Review

 

Systems Based
Practice


 Practice Guidelines


 EMTALA


 Discharge Planning


 HIPAA

Professional
Organizations


 Pediatrics
 

 Congratulations. You have completed the module and successfully intervened in the management of the most common chronic condition for  which children require medical care in the United States.

Now recall the objectives for this module:

  • Demonstrate skill in the application of clinical practice guidelines to a clinical situation.
  • Understand the role of the medical director and physician advisors for a health plan.
  • Identify opportunities for improvement of quality of care and cost containment.
  • Recognize the ability of physicians to control non-physician resources, such as medications, equipment and hospital observation status.
  • Understand the importance of complete and accurate information on referral and authorization forms.

If you feel you need to review this information, go back to review.

To review the clinical practice guidelines, visit the following sites:
 National Heart, Lung and Blood Institute
 UTMB Clinical Practice Guidelines 
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