Kentucky Managed-Care Utilization Review (MCR) is a state-funded program that is designed to ensure the delivery of quality health care services while managing costs for both providers and consumers. The program is managed by the Kentucky Department of Medicaid Services (DMS). MCR is used to evaluate the appropriateness, effectiveness, and efficiency of services provided by Medicaid providers. It also helps to ensure that Medicaid members are receiving the most appropriate health care services for their needs. The two main types of Kentucky MCR are Pre-Service Utilization Review (POUR) and Post-Service Utilization Review (POUR). POUR is used to evaluate proposed services prior to their being performed, to ensure that the services are medically necessary and appropriate for the Medicaid member’s condition and diagnosis. Post-Service Utilization Review is used to evaluate services after they have been performed, to ensure that the services were appropriate, effective, and medically necessary.
Kentucky Managed-Care Utilization Review
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How to fill out Kentucky Managed-Care Utilization Review?
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