Medical Utilization Management
The mission is to provide custom-made Medical Utilization Management to fit all of our individual client’s wants through the use of cutting-edge strategies and tools, in so doing delivering a feasible alternative to conventional Medical Utilization Management Services. We're dedicated to delivering our clients and also patients with exceptional replies for their individual healthcare needs and issues.
We realize that one of the most helpful, most well accepted, Medical Utilization Management programs will be "Patient-Centric". For that reason, our services focus on identification of patients who could benefit from the personalized attention plus assistance of the Skilled Registered Nurse in controlling their health condition(s). Virtually any patient with any health condition who is not at present implementing “Best Practices Medicine” would have been a candidate pertaining to our program. Once identified as a potential candidate for our services, the info available is screened by a case coordinator.
The main objective of this screener is always to determine the likelihood that one of our qualified Registered Nurses could either improve the quality of health attention the patient is receiving, and/or reduce the actual expense of the health attention the individual is receiving while not compromising the particular quality associated with medical attention being provided. The cost connected with this screening is contained in our administrative charge.
Our program is actually tailored to the uniqueness of not just every individual, but also every single client. We will be as aggressive or as passive in our interventions as you choose. We'll provide our expertise, details, and suggestions to you, however in the end it is you who will determine the amount of an investment you're able/willing to make as well as wherever you need to deploy that investment.
Strengths regarding our Medical Utilization Management:
We exclusively use nurses and physicians, never foreign call centers. We are the only Medical Utilization Management Company that does so.
Coordinate customer’s needs together with personalized programs as well as offerings.
One particular nurse handling one individual through their continuum of health care.
We reach every single individual pre and post hospitalization…no one else does.
Transplant management as well as physician involvement constantly equals enormous financial impact.
In house nurse on call, Twenty four hours a day, simply because we could not find a vendor that will take particular information for every client
High nurse- to- employee lives ratio. We have 1 Registered nurse for every Three thousand employee lives….Blue Cross Blue Shield has one for every 12,000 employee lives. United Healthcare provides one RN for every 60,000 employee lives. We have approximately 20 times more available nurses.
Competitively priced.
Guaranteed Performance of $3.00 in savings returned for every dollar spent.
Success at Medical Utilization Management claims cost reductions:
Group #1
Self-funded trust went from a 3.5 million deficit to a 4.5 million excess inside year One using our Medical Utilization Management services (as the only change made)! Year 2 the Plan made substantial ENRICHMENTS to benefits offered to their members and nonetheless experienced an additional Reduction in claims fees of 1 million dollars.
Group #2
Claims costs REDUCED by over 24%, and beat anticipated trend by more than 34%. Saved over 2.4 million in year 1 with the only change being including us.
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Bear in mind we guarantee a $3.00 savings in claims returned for each dollar spent for Medical Utilization Management *
Medical Utilization Management |