What does NUMI mean in MANAGEMENT

NUMI stands for National Utilization Management Integration, a program established by the Centers for Medicare & Medicaid Services (CMS) to improve the efficiency and effectiveness of utilization management (UM) processes for Medicare and Medicaid beneficiaries.

NUMI aims to streamline UM processes, reduce administrative burdens, and promote greater transparency and consistency in UM decision-making. It also seeks to improve patient access to necessary care and reduce unnecessary delays or denials of care.

NUMI requires providers to submit electronic prior authorization requests for certain services and procedures. It also standardizes the UM review process and timelines across participating health plans. This can help providers improve their efficiency and reduce administrative costs associated with UM.

NUMI is intended to make the UM process more transparent and efficient for patients. It provides patients with access to information about their coverage and UM decisions, as well as the ability to appeal denied requests.

NUMI applies to Medicare and Medicaid beneficiaries receiving services from participating health plans. It covers a wide range of services and procedures, including durable medical equipment, home health services, skilled nursing facility care, and specialty drugs.

Additional information about NUMI can be found on the CMS website at https://www.cms.gov/medicare/medicare-fee-for-service-payment/acuteinpatientpps/numi.