Utilization Management
More than a yes/no decision, pre-certification and concurrent review utilize accepted medical guidelines to determine the appropriateness of medical services as well as the delivery of care setting and length of stay. The Utilization Management staff will assist your employees to access the most cost effective treatment plan in close collaboration with the attending physician. Close concurrent review of each case allows for monitoring and interaction facilitating the level of care appropriate for each patient. Our Medical Directors are actively involved on a daily basis to oversee our Utilization Management process.
Utilization Management consists of:
- Pre-certification/notification of upcoming services
- Authorization of medically necessary services
- Concurrent review of all hospital stays
- Coordination of discharge planning
- Coordination of resources optimal for an individual’s healthcare needs
In addition to standard utilization management services, QCP also utilizes our state-of-the art computer system to identify those individuals who may benefit from Case Management intervention based on diagnosis or services being requested.
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