Utilization review staffing solutions to maximize the quality and cost efficacy of healthcare services

Thanks to utilization review, a patient's clinical needs can be matched to evidence-based criteria. This is vital, as it guides utilization review professionals in determining what level(s) and settings(s) of care are most appropriate. It's also a critical component of securing quality services, protecting resources, and protecting revenue integrity.

Our expert solutions in utilization review include those highly qualified in social work. From reviewing medical necessity for scheduled care before admission to care while admitted and to post-services care, our consultants partner with healthcare organizations and payers to manage the progression of care and determine what services are appropriate, justifiable, and reimbursable.