AllMed Healthcare Management

For Payers

Explore Our Clinical Webinars & White Papers For Payer Organizations

AllMed offers an extensive library of educational resources that help our clients stay abreast of emerging clinical procedures and therapies to support improved clinical decision making.

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Air Ambulance: Medical Necessity or Convenience?

Despite substantially higher costs, the use of air medical transportation can improve clinical outcomes when compared to traditional, ground-based transportation. A common challenge that payers confront is distinguishing when it is a medical necessity and when it is a convenience.  This webinar explored, through the lens of a patient case, the key factors that help establish when using an air ambulance is medically necessary.

Robotic-Assisted Gynecology Surgery

AllMed’s Medical Director Dr. David Spiro led an interactive discussion special guest Dr. Kelly Wright that examined the medical necessity of robotics in benign gynecology surgeries. This webinar reviewed the findings of an IRR quality review of a robotic-assisted hysterectomy case with the AllMed OBGYN peer panel and discussed when utilizing high-cost technology is medically necessary.

Balloon Sinuplasty

In this webinar we'll be reviewing the findings of an IRR regarding a balloon sinuplasty case, as well as a general discussion about the topic of balloon sinuplasty in the context of healthcare utilization.

This case was a 31 year old female with chronic sinusitis by history with a request for balloon sinuplasty. Our guest panelist, Dr. Stephen Maturo, is a board certified otolaryngologist who also took part in this quality program at AllMed.

AllMed Quality Programs

An overview of AllMed's Quality Program and Peer Performance Management System. This webinar features AllMed’s Senior Associate Medical Director Dr. Eric Diamond, MedReview Director of Clinical Operations Jen Mongeau, and Compliance and Accreditation Manager Alexandra Stromquist.

Urine Drug Screening

An interactive discussion with AllMed Medical Director, Dr. David Spiro and special guest Dr. Phong Nguyen. This webinar focuses on Urine Drug Screening (UDS), and the advocacy to combat inappropriate use of opioids and reduce illicit drug use.

Behavioral Health Utilization Management

A discussion with AllMed Medical Director, Dr. David Spiro and special guest Dr. Chris Esguerra. This webinar focuses on UM trends in behavioral health, and how evidence-based medicine streamlines the process to ensure objective reviews and prevents overutilization without compromising quality of care.

Prenatal Screening and Diagnostic Testing: Which Tests Are Medically Necessary?

The number of prenatal screening test options has increased in recent years. Non-invasive tests, such as ultrasonongraphy and certain blood tests, are part of routine prenatal care and can help determine whether more invasive tests are needed. Many tests, however, are often offered to all pregnant women. It is important to weigh the benefits and risks associated with these tests, which are not always without risk, particularly for the fetus.

Diabetes Management: When are Blood Glucose Monitoring Systems Medically Necessary?

Blood glucose monitoring allows patients with diabetes to understand patterns of blood glucose changes so that diet, exercise, and medication dosing can be adjusted as needed. There are numerous blood glucose monitoring systems, from basic models to those with multiple features and options. The cost of blood glucose meters and test strips varies, as well as health plan coverage for these products.