How Payer UR Intensity Has Actually Changed Year Over Year
Payer utilization review intensity has measurably increased year over year, not just anecdotally — Medicare Advantage insurers denied 7.7% of prior authorization requests in 2024, up from 6.4% the year before, while overall UR volume keeps climbing across the industry. The Trend Is Real, Not Just a Feeling Facilities running utilization review day to day […]
ASAM-Based Utilization Review Documentation: What Behavioral Health Charts Actually Need to Say
ASAM-based utilization review documentation for behavioral health depends on covering all six ASAM dimensions at every review, not just the two dimensions most charts default to — and as of 2026, payers themselves are now operating under a federal clock for how fast they have to respond. What a UR Reviewer Is Actually Looking For […]
Utilization Review in Behavioral Health: How Continued-Stay Denials Actually Happen
Utilization review in behavioral health depends on proving, over and over, that a patient still needs the level of care they’re in — and federal regulators have confirmed that proof gets demanded more often, and on a shorter clock, than it does for medical or surgical care. That’s not a facility’s imagination. It’s a documented […]