← All glossary termsUtilization Management (UM)
The broader payer function that includes prior authorization, concurrent review, and retrospective review to ensure appropriate use of healthcare services.
What it means
Prior authorization is one piece of a payer's larger UM strategy, which also includes reviewing care while it's happening and after the fact. Understanding UM as the umbrella helps position prior auth automation within the payer's full workflow rather than as an isolated tool.
