Optimize care processes to ensure quality outcomes and patient satisfaction
Our platform supports criteria-based reviews for medical necessity, detailed communication with payors, physician advisors, post-acute care providers and others. Using our utilization review and management software will help you avoid unnecessary readmissions by identifying patient populations at risk and providing tools that promote a smooth transition, or hand-off.
Highlights:
- Instant HL7 messages for updates to patient records in real-time
- Customize the configured rules for automatic identification of pre-admission, observation, admission, readmission and continued-stay reviews
- Automates referrals to internal and external physician advisors
- Provides care assessments, interventions and documentation to ensure continuity of care and effective hand-offs
- Standardized documentation and clinical information packets for use in payor contacts
- Variance tracking, including readmission assessments, and avoidable days and delays
- Integration with Change Healthcare’s Interqual and MCG CareWebQI medical necessity criteria

