Clinical practice in the United States is marked by significant variation, leading in some cases to suboptimal quality of care and poor health outcomes. Despite the proliferation of clinical practice ...

Concurrent review is a utilization review process that occurs while a patient is actively receiving treatment, such as during a hospital stay. It evaluates the medical necessity and appropriateness of ...

Humana will use healthcare technology firm XSOLIS’ predictive analytics platform to streamline parts of the utilization review process with providers. The payer will adopt the company’s various ...

I need to do a drug utilization evaluation (DUE) for a new product to be added to our formulary. What resources are available to develop a DUE? The formulary system encompasses facets of medication ...