U

Term: Urgent Prospective Review

A Utilization Review that must be completed sooner than a Prospective Review in order to prevent serious jeopardy to you or the patient's life or health or the ability to regain maximum function, or in the opinion of a Physician with knowledge of you or the patient's medical condition, would subject you or the patient to severe pain that cannot be adequately managed without treatment. Whether or not there is a need for an Urgent Review is based upon the Cost Containment Administrator's decision using the judgement of a prudent lay-person who possesses an average knowledge of health and medicine.


U

Term: Urgent Prospective Review

A Utilization Review that must be completed sooner than a Prospective Review in order to prevent serious jeopardy to you or the patient's life or health or the ability to regain maximum function, or in the opinion of a Physician with knowledge of you or the patient's medical condition, would subject you or the patient to severe pain that cannot be adequately managed without treatment. Whether or not there is a need for an Urgent Review is based upon the Cost Containment Administrator's decision using the judgement of a prudent lay-person who possesses an average knowledge of health and medicine.


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