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Insurance Utilization Management

Meaning

Insurance Utilization Management is a structured administrative process within the healthcare and wellness space designed to evaluate the medical necessity, appropriateness, and efficiency of proposed clinical services, treatments, and procedures, often including advanced hormonal therapies or diagnostics. This critical oversight function ensures that resources are deployed responsibly and that patient care aligns with established clinical guidelines and coverage criteria. While primarily administrative, its impact on patient access to specialized endocrine care is significant.