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Utilization management (UM) or utilization review is the use of managed care techniques such as prior authorization that allow payers, particularly health insurance companies, to manage the cost of health care benefits by assessing its medical appropriateness before it is provided, by using evidence-based criteria or guidelines.
Inflammatory: Arthritis, gout, rheumatoid arthritis, rheumatic fever Several other medical conditions can resemble RA, and need to be distinguished from it at the time of diagnosis: [ 93 ] Crystal induced arthritis ( gout , and pseudogout ) – usually involves particular joints (knee, MTP1, heels) and can be distinguished with an aspiration of ...
The act established the position of Associate Director for arthritis and related musculoskeletal diseases and authorized an interagency arthritis coordinating committee; community demonstration project grants; an arthritis data bank; an information clearinghouse; and comprehensive centers for research, diagnosis, treatment, rehabilitation and ...
As the largest single purchaser of medical services in the U.S., Medicare's fixed pricing schedules have a significant impact on the market. These prices are set based on CMS' analysis of labor and resource input costs for different medical services based on recommendations by the American Medical Association. [35]
Patients with rheumatoid arthritis often need a long term, coordinated and a multidisciplinary team approach towards management of individual patients. Treatment is often tailored according to the individual needs of each patient which is also dependent on the response and the tolerability of medications.
Acute pain is common in children and adolescents as a result of injury, illness, or necessary medical procedures. [94] Chronic pain is present in approximately 15–25% of children and adolescents. It may be caused by an underlying disease, such as sickle cell anemia, cystic fibrosis, rheumatoid arthritis.
Post-traumatic arthritis is a form of osteoarthritis and the former can occur after the latter. However, post-traumatic arthritis can also occur after the development of chronic inflammatory arthritis. Generally, post-traumatic arthritis is classified in two groups: post-traumatic osteoarthritis and post-traumatic inflammatory arthritis. [2]
Rheumatism [2] / ˈ r uː m ə t ɪ z əm / or rheumatic disorders are conditions causing chronic, often intermittent pain affecting the joints or connective tissue. [3] Rheumatism does not designate any specific disorder, but covers at least 200 different conditions, including arthritis and "non-articular rheumatism", also known as "regional pain syndrome" or "soft tissue rheumatism".
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