Utilization Management Services
A revenue integrity service for providers who want to use prospective reviews to select the right care settings for optimized reimbursement.
Help ensure that patients receive the most appropriate level of care while reducing your risk of medical necessity denials
Conduct placement-status reviews using InterQual® or another evidenced-based, clinical decision-making tool
Implement concurrent authorization services for admissions
Apply additional scrutiny when decision-support tools conflict with a physician’s clinical judgement, helping ensure additional documentation for medical necessity of care
Expand the number of cases you review, and focus on length of stay and highly complex cases that need specific clinical expertise
Track the ROI by using our reporting and analytics to keep you informed of performance