Utilization Management
A concurrent care program providing a prospective review of service and care plans
for acute and short-term illnesses. Conduent Care and Quality Solutions’ nurses
help contain overall costs by negotiating appropriate and cost-effective utilization
of inpatient, outpatient and professional services.
Key Benefits
- Improves plan efficiency by decreasing medically unnecessary services
- Proactively manages utilization by reviewing services before they occur rather than
through expensive and contentious post-service audits and reviews
Features
- Provides pre-service and concurrent medical necessity reviews of medical services
and treatment plans.