Medical Review Solutions For Improved Quality and Reduced Costs
Health plans and medical management organizations are confronting more and more challenges as the healthcare environment becomes increasingly regulatory and punitive. Not only do these organizations face a daily flood of healthcare claims, appeals, and pre-authorizations, they also must make objective determinations under tight deadlines.
Further complicating the determination process are the increasingly complex medical procedures and drug therapies along with constantly shifting standards of care. And, accessing on-demand specialty knowledge for timely decision-making can be difficult or even impossible.
This is where AllMed can help. We serve as an extension of your team, with medical advisors, master copy editors, and customer resources that enable you to improve your services and reach your goals.
With AllMed's medical review solutions, your organization gains access to our comprehensive solution to support medical management decision making across the spectrum of utilization, case management, grievances and appeals, and state and federal appeals. Our quality, independent medical reviews ensure that your organization's members receive superior care that meets medical necessity and coverage criteria, while controlling over-utilization. And, it happens in a turn-around time that meets your needs
Making clinical determinations is a critical function in healthcare payer organizations. With AllMed's easy outsourcing options, your health plan or medical management organization can reduce costs, all while ensuring high quality and compliance.
AllMed's Medical Review Solutions offer:
- Repeatable, consistent quality
- Customization to meet your exact needs
- Turn-around time exceeding URAC standards
All review are handled through AllMed's Peer Point Medical Review Portal, providing faster case processing, automation to reduce errors, and immediate access to cases, with no waiting. With Peer Point, your information is protected by the highest security standards in the industry.
Want to learn more about how AllMed's Medical Review Solutions can help you overcome the competitive and cost and pressures facing healthcare payers and medical managers? Download this free white paper.