HEALTHCARE UTILIZATION MANAGEMENT SOLUTIONS
Health plans, utilization management (UM) companies and managed care organizations alike are looking to streamline their operations and process service requests as efficiently as possible. Prior authorizations, the continuation of care and medical necessity evaluations are increasingly a challenge for many payer organizations. With a scarcity in nursing and physician advisor resources, plus volume fluctuations, it’s increasingly tough for many organizations to staff for and manage these critical functions. And with many demands on in-house Medical Directors, many payer organizations are increasingly partnering with companies like AllMed for processing their incoming service requests.
AllMed has been supporting utilization review and appeals departments for over 25 years, providing flexible services that align our workflow with your needs. We cover the spectrum of standards as dictated by your clinical protocols, including in-house medical policy, plan language, published care guidelines and latest standards of care.