Utilization Review and
Utilization Management

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