Case Management / Utilization Review Consulting Services
Case management and utilization review functions are a critical link between a healthcare organization's clinical and financial operations and growing more important as organizations position themselves for healthcare reform. Case management and utilization review staff can impact the quality of care, timely and appropriate reimbursement, and patient satisfaction all necessary focus areas for sustainability in the new era of healthcare.
Precyse provides CM/UR expertise to revitalize your CM/UR program, and can help provide solutions to help solve some of today's most challenging issues, such as:
Precyse's CM/UR Consulting Service provides a three phase approach including an independent assessment, program redesign and implementation, and on-going performance monitoring of your CM/UR program.
- Value-Based Purchasing initiatives (30-day Readmission, Medicare Cost per Beneficiary)
- Increases in avoidable days
- Unacceptable patient lengths of stay
- High cost per case
- Increasing denials related to patient status
Precyse offers well-rounded, seasoned consultants that not only possess expertise in CM/UR, but have experience in other areas, including clinical documentation improvement, coding, and other revenue cycle functions. This broader view of clinical plus revenue cycle issues and practices allows Precyse to create a more comprehensive and strategic plan to not only enhance the CM/UR program, but to also understand the clinical and revenue cycle impact of changes made to your program.