See how Northeast Health System leveraged CorroHealth’s Utilization Management expertise and the CMS 2+MN Rule to secure over $125M in revenue, setting a new standard for operational excellence and compliance. Learn from their journey.
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
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
Reimbursement Is Changing. Alignment Will Decide What Works
Reimbursement Is Changing. Alignment Will Decide What WorksThe future of healthcare reimbursement is being driven less by any single policy and more by mounting pressures across the system. Costs keep rising, administrative complexity remains high, and patients bear...
New CMMI Models Signal a Seismic Shift for Hospitals
New CMMI Models Signal a Structural Shift for HospitalsThe Centers for Medicare and Medicaid Innovation (CMMI) is reshaping how hospitals are paid, evaluated, and held accountable. The latest generation of payment models extends beyond incremental updates, increasing...
The Documentation Crisis No One Designed for
The Documentation Crisis No One Designed for – and the Shift That’s Fixing ItClinical documentation was never intended to carry the weight it bears today. At its core, documentation exists to capture clinical reasoning—what a clinician observed, assessed, and...
Regulatory Insights
Medicare Advantage: The New RACs
Since the onset of the 2-midnight rule, hospitals have been spared the onslaught of medical necessity denials from Recovery Audit Contractors (RACs). The RACs have certainly branched into other areas of audit in hospitals, but tightened claim limits have significantly...
Not Hitting Your Revenue Cycle Benchmarks? Look at Utilization Management.
It is a truism that hospital financial outcomes result from an interdependent web of departments contributing specific functions and deliverables, commonly referred to as the revenue cycle. Each silo – admitting, managed care contracting, utilization management,...
The Role of the Physician Advisor in the Observation Rate Conversation
By Jerilyn Morrissey, MD Twenty years ago, few hospitals thought of using a physician as a regular resource for utilization review purposes. My colleagues, Drs. Corrato, Zebrowitz, and McCarter introduced the Physician Advisor role to the industry in the early 2000s....