Utilization Management

Reduce Costs While Maintaining Quality Care

No two cases are alike. Every illness and injury demands individual attention to assure that care and costs are appropriate. In the event of an episode, illness or injury, we partner with the injured individual from the onset.

Our experienced utilization review nurses determine the most appropriate course of treatment according to established clinical criteria. They also continue to examine care and costs throughout the recovery process to ensure a positive outcome.

Our utilization management services include the following:

• Pre-certification
• Independent medical evaluations
• Concurrent review
• Provider bill review
• Hospital bill review
• Fee negotiation