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  • Utilization Management

Clinically Aligned Status Decisions. Financially Sound Outcomes.

Reduce administrative burden and avoid costly missteps with a utilization management strategy built for speed, precision, and alignment.

  • 23% Average Payment Increase per Medical Case
  • 40% Fewer Physician Advisor Concurrent Reviews
  • 60% Reduction in Concurrent Patient Status Reviews
  • 50% Decrease in Observation Rates
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UTILIZATION MANAGEMENT

Leveraging advanced data analytics with clinical expertise to strategically and compliantly combat payer denials

Physician Advisory

Strategic and programmatic approach to transform team performance

Analytics as a Service

Align critical metrics to your revenue goals

Admission Status Reviews

Proprietary data-driven review program to optimize patient admission status

Peer-to-Peer Reviews

We defend your patient care choices to secure fair reimbursement

Denials Management

Root-cause analysis and strategy to combat payer tactics

UM Resources

Inside AI-Driven Medical Coding

Inside AI-Driven Medical Coding

Inside AI-Driven Medical Coding Exploring AI and ML Technologies in Healthcare Workforce shortages, regulatory complexities, and economic challenges have put hospitals and health systems under immense pressure to improve operational efficiency, accelerate payments,...

The Limitations of CMI as a KPI

The Limitations of CMI as a KPI

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The Limitations of CMI as a KPI by Sam Dominik, Senior Vice PresidentTraditional hospital performance metrics like denial rates, CMI, LOS, and readmission rates hinder progress. It’s time to shift your perspective on KPIs.   Traditionally, a higher CMI indicates a...

Regulatory Insights

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Regulatory Bulletins

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