Utilization Management (UM) is a managed care strategy used to ensure that healthcare services are medically necessary, cost-effective, and of high quality. It is a process that evaluates the appropriateness of healthcare services and procedures, and helps to ensure that patients receive the most appropriate care. UM is used to control costs, improve quality of care, and ensure that patients receive the most appropriate care. It is typically used to review and approve or deny requests for services, such as hospital admissions, diagnostic tests, and treatments. UM also helps to ensure that healthcare services are provided in the most cost-effective manner. Some of the companies in the UM market include Aetna, Anthem, Cigna, Humana, UnitedHealth Group, and WellCare Health Plans. Show Less Read more
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