Utilization Management for Employers
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Utilization management is the first line of defense to effectively manage health
care costs. We ensure that your employees get the medically necessary care they
need in the appropriate setting. We also minimize or eliminate inappropriate levels
of care, admissions, and procedures, and preventing untimely or premature discharges.
Our utilization management program for inpatient services includes:
- Prior authorization
- Concurrent review
- Discharge planning and case management referral
- Retrospective review
- Prior authorization for organ/tissue transplants and nursing services.
We also perform:
- Outpatient procedure certification, including surgical procedures and extended outpatient
therapies
- Radiology reviews
- Durable medical equipment (DME) review.
Early Identification
We also use utilization management to identify employees who would benefit from
more intensive care management services. Early identification and engagement allows
your employees to better management their conditions and lead healthier, more productive
lives. Better management reduces your health care costs.
And because we have a single platform, we can seamlessly move your employees to
other care management programs as their health needs change.
Call 1.800.222.0771 to put KePRO Utilization Management to work for you! Or
contact our business development professionals directly.