Our Utilization Management program is an effective tool for assuring high quality patient care and making the most efficient and effective use of tax dollars budgeted.
Utilization management best practices include:
- Qualified clinical peer reviewers;
- Utilization management determinations—not healthcare determinations;
- HIPAA-compliant processes;
- Appropriately accredited Health Utilization Management organization;
- Support for state-specific hearing processes; and,
- A fair process for all participants, uncontaminated by conflict of interest.