Maximize the quality and cost efficacy of healthcare services
Ensuring expert guidelines are followed is critical while managing requests for medically appropriate and necessary medical services.
Our solution provides multi-faceted expertise to meet those guidelines, enhance quality outcomes in a cost-effective manner, and make sure patient safety is always put first.
- enhance medical necessity reviews
- meet HEDIS standards
- secure prior authorization, concurrent, and retrospective reviews
- improve documentation and tracking of peer-to-peer conversations, reconsideration reviews, and multi-level appeal processes
- Utilization Review Nurse / Specialist
- Social Worker
- Patient Care Coordinator
- Discharge Planner