Maintain Efficient Utilization of Healthcare Resources
AveCare's Integrated Utilization Review process supports a variety of Utilization Review functions for both inpatient and outpatient services enabling health delivery organizations to streamline medical review while maintaining Efficient Utilization of healthcare resources.
- Review Management: Processes for all aspects of utilization management including: prior authorizations, referrals, initial & concurrent, compliant & retrospective reviews.
- Notifications: Automated referrals to case management triage and notification to case managers that a pre-certification has been received.
- Review Tools: Features to enable efficient and speedy handling of cases including: copying of outpatient reviews to inpatient, automated letters, automated urgent queue tasks and many more.
- Medical Panel Review: Includes utilization of both internal and external medical review.
- Appeals: Detailed tracking of the appeal process.
- Criteria Integration: Provides interactive or online criteria solutions with multiple vendors.
- Correspondence: Integrated letters program to facilitate compliance during the utilization management process.
Next: Automated Workflows