Medical Review Solutions for Improved Quality & Reduced Costs
Claims, utilization review and case management professionals face an avalanche of healthcare claims, appeals and pre-authorization requests and are challenged to provide objective determinations under tight deadlines and other regulatory requirements. Increasingly, complex medical procedures and drug therapies along with constantly shifting care standards further complicate the job, thereby making it difficult to access on-demand specialist knowledge for timely clinical decision making.
Competitive and cost pressures are driving healthcare payers and medical managers to re-examine their core business processes and determine how to best focus their organizational resources on core strategic functions and competencies. While physician review is a critical function in healthcare payer organizations, it can easily be outsourced at low cost, while ensuring high quality and compliance.
This is why more claims and medical management organizations are partnering with AllMed to ensure members receive care that meets the medical necessity and coverage criteria, while controlling overutilization. With AllMed, you gain access to our comprehensive set of physician review solutions that span the entire spectrum of internal and external physician review processes.
Want to learn more? Download this free white paper.