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Utilization Review Criteria: Introduction to MCG (Part of the Hearst Health Network) (UR5000)


Author(s): Claudia Moore RN, QPCM, CCM


Pre-Approved for: CA BRN, CCM, CLCP, COHN/COHN-S, Delaware BON, RNs


Credit Hours: 4


Course Description

This course is an introduction to utilization review, specifically MCG (Milliman Care Guidelines).


Course Format

Online

Course Objectives

  1. Define the purpose and goals of MCG Care Guidelines (formerly Milliman Care Guidelines)

  2. Define the Clinical Indications for Admission to Inpatient Care and use these Indications to determine appropriateness of inpatient admission

  3. Describe the key features of:
    o the Optimal Recovery course
    o the Discharge Planning Resources

  4. Define and differentiate between:
    o Recovery Milestones and Care Elements
    o Four types of variances

  5. Apply the MCG Care Guidelines to manage the Inpatient progression of care

Course Overview

Outline

Utilization Review Criteria: Introduction to MCG (Part of the Hearst Health Network) - Introduction
  1. General Introduction to the Utilization Review Criteria: Introduction to MCG (Part of the Hearst Health Network))

  2. Inpatient and Surgical Care
    1. Introduction
    2. Applying the Clinical Indications for Admission or Procedure
    3. Maximizing Use of the Optimal Recovery Course
    4. Discharge Planning Resources
    5. The Basics

  3. Case Studies - Practice Test
The excerpts from the MCG (Part of the Hearst Health Network) , Copyright 2014, are reproduced with permission. These excerpts are incomplete and are not licensed for any use whatsoever. Further reproduction or distribution of all or any portion of the MCG (Part of the Hearst Health Network) is strictly prohibited.

Course Price

$32.00

Customer Testimonial

Excellent class. Exceptional staff delivering invaluable guidance. I give it a AAA plus! Thank you.
Faye M.