In keeping with its expanding services to leading payers, AllMed Healthcare Management has received its Health Utilization Management (HUM) Accreditation from URAC. This complements the company’s IRO accreditation, which has been in place since 2000.
For over 20 years, AllMed Healthcare Management has dedicated itself to improving the quality and integrity of healthcare, through its physician peer review services. The company partners with leading national and regional health insurers, managed care organizations, TPAs and PBMs to increase patient access to high quality care, while reducing overutilization.
AllMed’s URAC HUM Accreditation demonstrates its continuing dedication to conducting utilization management that is clinically sound while respecting both patients’ and providers’ rights.
Over the past several years, AllMed has delivered high quality care management decision making services to leading UM departments and managed care organizations, in support of their pre-authorizations, concurrent reviews and appeals processes. With this accreditation in place, AllMed’s clients can be confident that AllMed:
- Is a reliable UM partner for conducting the full scope of medical necessity reviews — from initial clinical review to peer clinical review, along with end-to-end services including benefit determinations, customer service and patient/provider communications
- Uses evidence-based treatment guidelines to enhance the quality and effectiveness of patient care while eliminating excessive treatment and expense
- Consistently meets regulatory standards for turnaround times in both urgent and non-urgent review determinations while providing world class quality standards
- Understands and adheres to applicable state and federal regulations
- Employs drug utilization management mechanisms to address therapeutic appropriateness, over and underutilization, dosage, duration of treatment, duplication, drug allergies, and more
- Is prepared to address any risk to patient safety, such as contraindicated treatments, adverse drug interactions, or inappropriate treatment, during the review process
With AllMed, clients have the ability to accelerate prior authorizations, concurrent reviews and appeals while streamlining their processes with cost-effective management of their medical reviews.
AllMed works closely with its clients. Whether it’s full-spectrum UM or denial management to support in-house nursing resources, AllMed works to meet all its clients’ UM needs.
AllMed’s HUM accreditation from URAC is just one more example of the company’s long-term commitment to both its clients and their clinical excellence. This commitment continues to be rewarded and is the reason AllMed’s clients remain its loyal partners, year-after year.
Founded in 1990, URAC is the independent leader in promoting healthcare quality through leadership, accreditation, measurement and innovation. URAC is a nonprofit organization using evidence-based measures and developing standards through inclusive engagement with a range of stakeholders committed to improving the quality of healthcare. Our portfolio of accreditation and certification programs span the healthcare industry, addressing healthcare management, healthcare operations, health plans, pharmacies, telehealth providers, physician practices, and more. URAC accreditation is a symbol of excellence for organizations to showcase their validated commitment to quality and accountability.