Utilization Review
- 48 Hour Turnaround
- Evidence Based Guidelines
- Compliance With Rules and Regulations
Other Services
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HCRG’s comprehensive Utilization Review program focuses on fair and impartial decisions
through the use of Evidence Based Medical (EBM) guidelines and other guidelines
as mandated by state specific requirements.
Utilization Review Services::
- Prospective Review
- Concurrent Review
- Retrospective Review
- Peer Review
Tools and Skills Include:
- A Team of Multidisciplinary Professionals
- A Team of Well Trained Administrative Support Personnel
- An Accountable Management Infrastructure
- CMIS® Software (Care Management Information System)
- ACOEM Guidelines/Evidence Based Guidelines
- URAC Driven Policies and Procedures
- A Rigorous Continuous Quality Improvement Program
- State Specific Guidelines
Results:
- On Time Delivery of UR Decision
- Prevention of Service Duplication
- Provider Performance Data Tracking
- Compliance with Regulations Documentation
- Timelines Tracking and Notification
- Clear and Effective Reports
- Continuous Quality Management
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