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Utilization Review Case Study - Medical Management Preauthorizations

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.

Case Study: American Health HoldingsThe Challenge

American Health Holding (AHH) provides medical management services across the continental United States for a variety of TPAs, ASOs and even some self-funded employer groups. They thoroughly review approximately 142 appeals per month, and send an average of 30 appeals a month to AllMed for external review.

The Solution

AHH chose AllMed because of its URAC accreditation, and because it already had over 400 physicians in all medical specialties and had validated their accreditation and state licensing.

“We’ve found AllMed very helpful when our nurses or clients want more detailed explanations or references.”

 

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