🩺 UR in a Nutshell 💻 Here’s what a real Utilization Review nurse does in a day — using clinical judgment, MCG criteria, and documentation to decide if a case meets inpatient criteria or needs MD review 👀 This is just a quick sample case, but imagine getting to do this from home, on your laptop, helping patients while sipping your coffee ☕ and still using your nursing brain 🙌 If you’ve ever wondered what UR nurses actually do (and if it’s right for you), my Fundamentals of Utilization Review
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Why understanding utilization review is key for physicians As physicians, it’s important to understand the role of utilization review staff in the healthcare system. While nobody likes to play the game of ensuring proper admission status, it’s a necessary part of ensuring the hospital gets paid for the care provided. If the admission status is incorrect, the hospital could receive no payment for the entire stay of the patient, even if they received great care from the physician. Utilization revi
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