Utilization Review and Management

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 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

Want to learn more?

Contact us or request a demo. We’re ready to help!

Want to make patient transitions easier? Read this!

Enter your name and email below to download “Why Consider an Automated Solution for Care Management” and find out what you can do to streamline patient transitions at your facility.

Want to make patient transitions easier? Read this!

Enter your name and email below to download “Why Consider an Automated Solution for Care Management” and find out what you can do to streamline patient transitions at your facility.