Utilization Management

Our Utilization Management services provide our clients with a full set of staff to complete the utilization review processes and consultation across your program and service provisions to drive improved authorizations and success rates for your patients. The utilization management process includes authorizations and concurrent reviews being completed for your patients yet there is much more to this process. We work with your team to ensure that the correct information is obtained during the verification of benefits process to identify services and plans that require authorization or notification. We quickly work to notify the payor or obtain authorization for the services being rendered.

We stay on top of each patient episode and communicate with case managers across your payors to ensure your patients receive the care they need and that it is not shortened by the restrictive practices of their benefit plan.

We take our relationships with your payors and their case managers very seriously as we are a reflection of your team and the benefits of positive relationships and perceptions of your practice by the payers can have a tremendous impact on your patients care and future opportunities for your practice.

Our utilization management service extends into your practice and provider teams. We work with your management to ensure staff are continually trained and supported in providing timely and quality documentation that affects your patient’s care and your ability to get paid.