PPC Downloads

Joint Commission Standards Guide to Hospital Peer Review

 

The Cutting Edge - Treatment of Multiple Myeloma

This informative guide for Utilization Review and Claims Managers, includes medical updates on the following topics: Treatment of Multiple Myeloma; Early Penile Rehabilitation Following Radical Prostatectomy; Insulin Pumps: Deciding When They Are Medically Necessary; Does Shockwave Therapy Help Plantar Fasciitis; and Adult Growth Hormone Deficiency.

The Cutting Edge - Solitary Pancreas Transplantation

This Cutting Edge Guide provides clinical updates for Utilization Review and Claims Professionals on the following topics: Solitary Pancreas Transplantation; Lyme Disease: What's the Benefit of Antibiotic Therapy for Long-Standing Symptoms; Eight Steps to Treating Combat PTSD; and Developmental Delay: How to Diagnose, Plan Exclusions

The Cutting Edge - Oncology Edition

This Cutting Edge Guide contains Oncology related articles for Utilization Review and Claims Professionals on the following topics: PET Scanning in Oncology, Avastin Therapy in Oncology, MRI for Breast Screaning and Diagnosis, and Avastin Treatment for Glioblastoma.

How IROs Support Utilization Review & Medical Management

Sorting Out the Patient Care Puzzle—The Role of IROs and Medical Management Companies

Utilization Review Case Study - Medical Management Preauthorizations

Case Study: American Health Holdings

Independent Medical Review Case Study

Ensuring Quality / Determining Necessity Case Study about Capital BlueCross and how they used a AllMed as their Independent Review Organization to assist in making Medical Claims determinations.

Whitepaper - Best Practices in Hospital Peer Review

Whitepaper discusses why Peer Review is not working, and how and Independent Review Organization can help in the process.

Hospital Peer Review Case Study

A case study on Bay Area Hospital who uses AllMed to conduct Hospital Peer Reviews.

Hospital Peer Review Data Sheet

Datasheet on Improving Quality Management and Best Practices in Your Hospital

Disability Claims Review Datasheet

Datasheet on Using Independent Review Organizations to Reduce Claims Cost

Disability Review Case Study

Case study on Educators Mutual Life Insurance Company who used AllMed to conduct Medical Reviews to ensure all deserving disability cases are paid.

Meeting OPPE Standards

JFK Case Study

Medical Review Standards Guide

 

External Peer Review as a Risk Minimization Strategy

 

Using Outside Specialists to Pre-Approve Services

Case Study Q-Elements

IRO's Help Meet Rigorous State Appeals Guidelines

Case Study on HealthGuard of Lancaster, Inc.

Learn about The Joint Commissions new standards

This FREE guide covers the new Joint Commission Standards and how external peer review can help keep your hospital in compliance.

The Cutting Edge V1i1

Designed as a clinical update for Claims and Utilization Review Professionals this guide is geared to inform them on the latest treatments, hot topics, and their medical necessity.

The Cutting Edge V2I1

Designed as a clinical update for Claims and Utilization Review Professionals this guide is geared to inform them on the latest treatments, hot topics, and their medical necessity.

The Cutting Edge V2I2 Oncology Edition

Designed as a clinical update for Claims and Utilization Review Professionals this guide is geared to inform them on the latest treatments, hot topics, and their medical necessity.

Utilization Review Guide

Sorting Out the Patient Care Puzzle: The Role of IROs and Medical Management Companies

Utilization Review Case Study

Learn how a leading medical management organization met the challenges of finding specialists that met state licensure requirements and increasingly strict state regulations by outsourcing to AllMed.

Independent Medical Review Case Stud

Discover how one healthcare payer uses AllMed to help independently scrutinize their complex and questionable cases while maintaining quality and ensuring that patients are receiving the best possible care.

Best Practices in Hospital Peer Review

This whitepaper explains the problems that can arise from conducting in-house peer reviews, and how external peer review can be a great low cost alternative.

Hospital Peer Review Case Study

 

Hospital Peer Review Data Sheet

 

Disability Claims Review Data Sheet

 

Meeting OPPE Standards

 

Client Standards Guide

 

External Peer Review as a Risk Minimization Strategy

 

Using Outside Specialists to Pre-Approve Services

 

IRO's Help Meet Rigorous State Appeals Guidelines

Case Study of HealthGuard of Lancaster, Inc.

Download Peer Review Scorecard©

 

Download Our Free Case Study

 

Surpass OPPE and FPPE Standards with PeerScore

An overview of the services provided by PeerScore

Medical Review Solutions Designed For Payer Organizations

 

Services for Payers Brochure PPC

AllMed Healthcare Management provides medical review solutions that accelerate pre-authorizations, claims and appeals and that reduce costs for health insurance carriers, medical management, TPAs and stop-loss organizations. Our outsourcing solutions cover a spectrum of needs, including first-level pre-authorizations, complex and critical claims, appeals, medical director services and staffing services.

Surpass OPPE and FPPE Standards with PeerScore

PeerScore is designed ensure consistently objective and meaningful medical evaluations that improve the quality of patient care.

The Business Case for Outsourcing First-Level Physician Review White Paper

This white paper highlight what health plans, TPAs and medical management organizations are going through as they consider outsourcing first-level physician review in order to reduce fixed costs.

Busines Case White Paper

This white paper highlights what health plans, TPAs and medical management organizations are going through as they consider outsourcing first-level physician review in order to reduce fixed costs.