Utilization Management Program of the Naval Hospital Guam - Case Study Example

Only on StudentShare

Extract of sample
Utilization Management Program of the Naval Hospital Guam

Specialist Referrals- The Primary Care Physician (PCP) may request a consultation from a participating specialist physician at any time.The PCP determines the number of visits authorized.Specialists may include - Gynecologist, Radiation Oncologists, Ophthalmologists, Pediatric Ophthalmologists, Retinologists and Allergists etc.
Emergency Room Services -An emergency medical condition is defined as a condition that manifests itself by acute symptoms of sufficient severity (including severe pain) that a prudent layperson with an average knowledge of health and medicine could reasonably expect the absence of immediate medical attention to result in any of the following:
Out-of-Plan Referrals- All out-of-Plan referrals require Plan prior authorization at Guam. These requests are reviewed on an individual basis. Determinations are made based on the patient's medical needs and the availability of services to meet these needs within the provider.
Tertiary Care Services- All referrals to plan tertiary care centers are reviewed on an individual basis.The member's medical needs and the availability of requested services within the non ...Show more

Summary

The Utilization Management Program of the Naval Hospital Guam facility is one which is designed to ensure that high quality, cost efficient health care is delivered to all members of the community. The Utilization Management Division is responsible for implementing a Utilization Management Plan which will monitor the appropriate usage of the health care facilities, services and its resources…
Author : tyrellbernhard
Save Your Time for More Important Things
Let us write or edit the case study on your topic
"Utilization Management Program of the Naval Hospital Guam"
with a personal 20% discount.
Grab the best paper

Related Essays

Hospital Case Management
It spans all the departments of the hospital. The department looks at providing patients with optimal healthcare. The department is a part of the healthcare network that coordinates health care delivery and transportation. It also includes medical social work.
3 pages (750 words) Essay
Naval Hospital Guam Color Guard
The commemoration ceremony was a symbolic way to remember the Prisoners of War (POWs) and those Missing in Action (MIA) from the wars. Vice Admiral Doug Crowder, Commander of the U.S. 7th Fleet delivered a speech about the Navy's future. Adm. Crowder said, "Part of the mission is to turn this Navy over in the better shape than we found it to those who come behind us.
2 pages (500 words) Article
Quality Improvement Program of Naval Hospital
The performance improvement programs conform to the quality assurance programs as detailed in USNHGUAMINST 6320.19 series, BUMEDINST 6010.13 series, and Joint Commission on Accreditation of Healthcare Organizations (JCAHO) standards. A systematic approach of integration of total quality principles with performance improvement programs is followed through education, consultation, facilitation, and technical support.
3 pages (750 words) Essay
Naval Hospital Guam Facility
Health care for family members is also available at the COMNAVMARIANAS clinics. The range of medical services offered at the facility includes "family practice, OB-GYN, pediatrics, general surgery, anesthesia, internal medicine, psychiatry, psychology, occupational health and preventive medicine, emergency medicine, dental surgery, urology, otolaryngology, ophthalmology, optometry, acute care, physical therapy, Dietician, Health Promotions and social work services" (U.S.
3 pages (750 words) Case Study
Sales Management project
However, saying that is easier said than done. In most organizations, a lot of time and resources are spent on finding the right personal and same is the case with finding the people who make up an organization’s salesforce.
6 pages (1500 words) Essay
Find out how much would it cost
to get a custom paper written by a pro under your requirements!
Win a special DISCOUNT!
Put in your e-mail and click the button with your lucky finger
Your email
YOUR PRIZE:
Apply my DISCOUNT