Ensuring appropriate level of care placement every day is essential for revenue optimization.
Achieve excellence in utilization review by increasing your revenue and shortening your revenue cycle with accurate medical necessity determinations with after-hours coverage on nights, weekends and holidays.
Improving Patient Outcomes
with physician advisors possesing at least 5 years clinical + 3 years UM experience
Reinforcing Revenue Integrity
with customized reporting metrics that identify potentially missed revenue
Optimize patient care, reduce denials and maximize reimbursement through our unique approach to achieving excellence in utilization management.
Discuss your hospital’s utilization and denial management needs with our team.
Coverage Available
7 Days a Week
365 Days a Year
- LIVE coverage hours = 12 hours on weekdays; 8 hours on weekends
- Two-hour turnaround time during LIVE coverage hours
- Cases sent outside of LIVE coverage hours returned by noon the following day
Is Your Hospital Losing Money Over the Weekend?
The impact of weekend utilization review on reimbursement
It’s common to find hospital utilization management teams and physician advisory staffing lower during weekends. Lower staff levels can lead to delays in patient determinations that ensure treatment is at the appropriate level of care (LOC). Staffing issues can also stall discharges, keeping patients in the hospital even though they are ready to leave. Both scenarios can negatively impact quality of care, the patient experience, and hospital resources. Prolonged hospital stays have been linked to an increased risk of hospital-acquired infections and other complications, while poor triage and discharge processes impact patient satisfaction scores (HCAHPS). All of these have financial ramifications that should be mitigated.
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