Utilization Management Services
A revenue integrity service for providers who want to use prospective reviews to select the right care settings for optimized reimbursement.
AlignCare Needs With Reimbursement Requirements
- Help ensure that patients receive the most appropriate level of care while reducing your risk of medical necessity denials
- Implement concurrent authorization services for admissions
- Expand the number of cases you review, and focus on length of stay and highly complex cases that need specific clinical expertise
- Conduct placement-status reviews using InterQual® or another evidenced-based, clinical decision-making tool
- Apply additional scrutiny when decision-support tools conflict with a physician’s clinical judgement, helping ensure additional documentation for medical necessity of care
- Track the ROI by using our reporting and analytics to keep you informed of performance
Utilization Management in Healthcare
A Flexible Resource Customized to Your Needs
- Engage our services to augment your existing staff or use our team as a complete solution.
- We can also provide a bridge to in-sourcing by educating and training your team, helping you build a strong internal prospective review program.
- We track and report on several key performance indicators so you can both assess ROI and drive continuous quality improvement in utilization management.
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