Storing UR documents

HCPRO Website, March 18, 2016

Q: Our utilization review (UR) team is researching new database solutions for our electronic documents, as well as the remaining paper documents. How can we determine what solutions will best meet our needs?

A: Store electronic documents related to UR (e.g., denial worksheets) in a secure database accessible by authorized user ID and password. If the processes are paper-based, consult with the administration’s compliance officer to determine how many years the documents must be retained in a secure file in the UR office. Under public law No. 92-603 data collected by the utilization reviewers and the UM committee is confidential and is not considered discoverable or admissible in a court of law.

For more information about utilization review teams and staffing, see the book The Hospital Guide to Contemporary Utilization Review.

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