AllMed Healthcare Management

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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Applied Behavior Analysis (ABA) Therapy for Autism Management
Autism spectrum disorder (ASD) is a complex neurological developmental disorder that impacts millions of people. One of the best-established therapies for autism is ABA therapy. This treatment is intensive and must be provided on a long-term basis to achieve optimal results. The questions many health plans, managed care organizations and providers struggle with is which patients benefit from this form of therapy, how long this treatment is appropriate and what to look to help determine whether ABA therapy is medically necessary and appropriate.

Treating Opioid Addiction: Best Practices, Challenges and What Lies Ahead
Through our partnerships with leading payers and MCOs, we see a tremendous increase in requests for addiction recovery services. Despite this, research shows that many of those in recovery struggle to gain access to the quality care they need and deserve. Ambiguity around standards of care and how to effectively treat co-existing mental health disorders contribute to the difficulty, complexity and expense of treating substance use disorders. AllMed is committed to advocating for quality, evidence-based care. During this educational webinar, AllMed shared what works, what doesn’t and challenges for providers and payers when treating opioid addiction.

Observation vs. Acute Inpatient: What’s All the Fuss?
When admitting a patient to the hospital the attending physician must determine the medical necessity for an acute in-patient admission vs observation level of care. These levels of care often have very similar medical interventions but very different financial implications for both the patient and the facility. This webinar clarified the differences between acute inpatient and observation levels of care and discusses the considerations for both payers and providers when assessing medical necessity. The AllMed Medical Director team of Hospitalists and Internists dissected the issue and reviewed the decision-making process utilizing a real patient case as a learning tool.

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.