U.R.N.

Health care utilization review services; medical cost management; organizing and administering a network of health care providers; health care cost management and review services, namely, assessing appropriateness of medical procedures and providing opinions and options related to same; organizing and administering a network of health care provider specialists in the areas of chronic and complex diseases, catastrophic illness and surgery; collection of medical business and directory information, namely, collecting information from health care professionals and health care provider organizations regarding the outcomes, structure, processes, and effectiveness of health care professionals and health care provider organizations, analyzing such information, disseminating such information to provide recognition to the health care professionals and health care provider organizations which meet certain criteria, and providing such directory information to health care professionals and health care provider organizations for further use; medical case management and disease management services, namely, medical referral of individuals to appropriate health management programs

Insurance claims administration; insurance claims processing

Education services, namely conducting seminars, courses, conferences, audio conferences, online seminars, online presentations on medical conditions and in the field of continuing medical education and health care, and distribution of course materials in connection therewith

Providing health information; providing information regarding the outcomes, structure, processes, and effectiveness of health care professionals and health care provider organizations to health plan members for use in evaluating and selecting health care professionals and health care provider organizations; nurse information services, namely, nurse triage and nurse call centers providing information regarding specific health-related concerns and general health issues