PRIOR AUTHORIZATION

Nurse and physician reviews to augment your internal capabilities

PRIOR AUTHORIZATION REVIEWS

STREAMLINING UTILIZATION REVIEWS TO REDUCE COSTS

AllMed offers Prior Authorization reviews spanning all three types of utilization reviews, including:

  • Prospective—reviewing approval request before the start date of your member’s care
  • Concurrent—reviewing approval request as your member is receiving care
  • Retrospective—reviewing approval request post your member receiving care

Our panel of U.S. licensed nurse and physician reviewers use their clinical expertise and in-depth knowledge to complete all utilization reviews.  We review both non-specialty and specialty-matched cases where our clients observe high utilization of services.

We pay close attention to the nuances and human implications of each case as we partner with you to deliver high quality, evidence-based reviews. Our services are available seven (7) days a week, including holiday coverage, so that your internal team can focus on other ways to improve member care.

MEDICAL REVIEW SERVICES

MedCert

First-level nurse and physician reviews to streamline prior authorizations and concurrent reviews

MedReview

High-quality defensible determinations for complex specialty-matched prior authorizations 

Smiling female doctor standing with medical colleagues

SPECIALTY-MATCHED PRIOR AUTHORIZATIONS

Draw on specialized expertise for standard of care and complex procedures to minimize downstream appeals and costs.

SUPERIOR QUALITY THAT MAKES A DIFFERENCE

All of our services are deployed through PeerPoint, AllMed’s advanced medical review portal, which embeds healthcare intelligence and automation tools that produce the highest quality reviews at industry-leading turnaround times and costs.

But what makes us different is our people. Our commitment to consistently exceeding our clients’ expectations through everything we do, is why AllMed’s clients remain loyal partners, year-after year. We take special care to recruit the highest quality talent as well as train, grow, and engage them in our Lean management system. As a values-based company that puts culture first, our employees care deeply about each member’s health and about delivering the highest quality care.

REACH OUT
Interested in our review services?

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

ACCREDITATIONS