UM Operations
Utilization Management Organization (UMO)
Draft — pending verification
This reference entry has not yet been verified against its authoritative source (Original definitions; regulatory facts to be verified against CMS-0057-F (89 FR 8758) and X12/HL7 documentation). Do not rely on it for production configuration until this notice is removed.
In more depth
In the 278 transaction, the UMO is a defined role: requests are addressed to the UMO and responses come from it. Delegation matters operationally because a member's authorizations can be split across multiple UMOs (medical, behavioral, radiology, lab), which complicates unified views like the Patient Access API's PA data.