Utilization Management
Flexible, evidence-based reviews, designed to meet your changing needs and ensure compliance with industry, state, and federal requirements while delivering members the highest level of appropriate care.
Nurse Reviews
Nurse and physician prior authorizations, spanning from prospective, concurrent and retrospective review, augment your internal capabilities while containing costs.
Specialty Matched Prior Authorizations
Minimize the need for downstream appeals and costs with customized, specialty-matched authorization reviews. Draw on the expertise of our highly qualified physician peer reviewers for complex, evidence-based determinations.
Independent Appeals
High quality, evidence-based first and second-level reviews by specialists are delivered to the standards you expect and help your organization reduce costs and improve quality.
External Appeals
These comprehensive, high-quality reviews follow federal and state regulations and are monitored and managed through our in-house compliance program.
REACH OUT
Interested in using our review services?
Whether you need specialized expertise or added review capacity,
we’re here to help with customized services that fit your exact needs.