INITIAL CLINICAL REVIEW SERVICES

Scale quickly and efficiently when prior authorization, concurrent review, or RN staffing levels fluctuate

INITIAL CLINICAL REVIEW SERVICES

Partnering with AllMed gives you the ability to manage utilization review functions with greater agility and cost-effectiveness. Our dedicated cohort of US-licensed registered nurses (RNs) provides the essential clinical reviewer expertise you need when you need it, enabling you to focus on strategic priorities.

Initial Clinical Review Services include:

  • Prior authorizations of services and procedures
  • Prior authorizations of medications
  • Pre-certifications
  • Inpatient admission
  • Concurrent reviews
  • Level of care reviews
  • Continuation of care (inpatient and outpatient)

CHANGING DEMAND, FIXED RESOURCES FOR UTILIZATION REVIEWS

While demand for healthcare services is rising in the U.S.,1,2 the need for specific services can vary from week to week. Given the ongoing U.S. nursing shortage,3 staffing for this variable demand poses significant challenges for payers:

  • Additional pressure on turnaround times when case volumes surge
  • Mismatch between skills needed and available on staff
  • Higher cost of training, retention, and management
  • Increased recruitment effort and associated overhead
  • Focus on cost reduction as part of a strategic initiative

 

At AllMed, we designed our Initial Clinical Review services with these challenges in mind.

HOW TO QUICKLY SCALE TO MEET YOUR INITIAL CLINICAL REVIEW NEEDS

Our US-licensed RNs work as an extension of your team, integrating seamlessly into your organization. We are here when you need us, enabling you to:

  • Deliver accurate reviews securely, efficiently, and in full compliance with URAC, HITRUST, and state and federal regulations
  • Meet tight turnaround times when demand surges
  • Free your internal resources to focus on strategic priorities
  • Improve your RN retention and engagement
  • Reduce training, recruiting, and management costs

 

Our track record speaks for itself—over 98 percent of reviews are delivered within required turnaround times, leading to improved responsiveness and lower overall costs.

FEATURED UTILIZATION REVIEW RESOURCES

INITIAL CLINICAL REVIEW SERVICES

Scale quickly and efficiently when prior authorization, concurrent review, or RN staffing levels fluctuate by partnering with AllMed. Download this brochure to learn how we support your utilization review needs.

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INTERESTED IN OUR INITIAL CLINICAL REVIEW SERVICE?

Whether you need access to clinical review expertise or added review capacity,
we’re here to help with customized services that fit your exact needs.

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