The Utilization Management Committee: Strategies for coordinating Medical Practice with Hospital Goals


Instructor: Bernadette Benta
Product ID: 706303
Training Level: Intermediate to Advanced

  • Duration: 60 Min
This webinar will provide a detailed overview of proven strategies that maybe employed to ensure that hospital goals are aligned with medical practice. This is key to delivering high-quality coordinated care to produce Quality Patient Outcomes and Cost-Effectiveness. There will be special focus on the Utilization Review Committee (URC) as a CoP.
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Why Should You Attend:

The Utilization Review Committee is of great importance given the mandated status and functions it serves, roles and responsibilities and level of staff involved. However, some hospitals neglect to meet at regularly scheduled times or not at all.

This leaves then open to citations by Governmental and commercial payers actively engaged in monitoring hospitals adherence to UR requirements and the medical necessity of medical and surgical care.

Areas Covered in the Webinar:

  • The Utilization Review Committee: creating one; the roles and responsibilities; selecting members.
  • The Condition of Participation
  • Who should be excluded?
  • Physician Participation and Ownership
  • Key Documentation
  • Improving Engagement
  • Outcomes and Content

Who Will Benefit:

  • Physicians, Registered Nurses, Case Management Leaders, Hospital Administrators, Utilization Management Leaders
Instructor Profile:
Bernadette Benta

Bernadette Benta
Division Chief, Maryland Department of Health

Bernadette. A Benta, MSHA, BSN, RN is a Strategic Leader and Subject Matter Expert with twenty years of Operational experience in Care Management , Utilization Review and also works to develop Population Management programs.

She is a seasoned Consultant on both in Acute Care hospitals, Managed Care Organizations and serves as a Clinical Liaison of for Revenue Management programs. Ms. Benta possesses expert knowledge of Medicare and state-specific Medicaid knowledge, and does some does some SME work for the government. She has proven experience in building departments from the ground up and improving process in both payer and health system settings and identifying trends which impact service delivery for quality improvement and solutions to non-standard requests and problems. Seasoned Nationwide Healthcare consultant.

Topic Background:

The Conditions of participation: Utilization Review states the following:

The hospital must have in effect a utilization review (UR) plan that provides for review of services furnished by the institution and by members of the medical staff to patients entitled to benefits under the Medicare and Medicaid programs. The Utilization Review (URC) committee is the only committee required in the CoP.

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Registrants may cancel up to two working days prior to the course start date and will receive a letter of credit to be used towards a future course up to one year from date of issuance. ComplianceOnline would process/provide refund if the Live Webinar has been cancelled. The attendee could choose between the recorded version of the webinar or refund for any cancelled webinar. Refunds will not be given to participants who do not show up for the webinar. On-Demand Recordings can be requested in exchange. Webinar may be cancelled due to lack of enrolment or unavoidable factors. Registrants will be notified 24hours in advance if a cancellation occurs. Substitutions can happen any time. On-Demand Recording purchases will not be refunded as it is available for immediate streaming. However if you are not able to view the webinar or you have any concern about the content of the webinar please contact us at below email or by call mentioning your feedback for resolution of the matter. We respect feedback/opinions of our customers which enables us to improve our products and services. To contact us please email [email protected] call +1-888-717-2436 (Toll Free).




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