UMR’s Utilization Management services ensure that members receive the highest quality health
care services in a cost-effective manner. Services are performed by experienced review specialists
using advanced software and nationally accepted, evidence based guidelines.
The UMR Utilization Management program is URAC-accredited to meet recognized
industry standards. UMR implements extensive management techniques to ensure your member’s
needs are met as effectively and cost-efficiently as possible.
Utilization Management services include:
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Monitoring of pre-notification, hospital discharge planning and home health care
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Ongoing review of inpatient, behavioral health, skilled nursing facility, acute
rehab and outpatient services
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Coordinating durable Medical Equipment, such as wheelchairs and home oxygen
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Identification and referral to UMR’s Case Management and Disease Management
programs
