The administrative burden of utilization review processes like prior authorizations and concurrent review has long been a thorn in the side of healthcare providers. While prior authorizations have ...

Concurrent review is a utilization review process that occurs while a patient is actively receiving treatment, such as during a hospital stay. It evaluates the medical necessity and appropriateness of ...

How MCG Indicia software (enhanced with AI capabilities) has improved medical necessity documentation and increased hospital staff efficiency The sources of EHR data that are beneficial in determining ...

By meeting these standards, ProPeer demonstrates that its utilization management program operates with transparency, clinical rigor, and accountability, providing clients with confidence that reviews ...

Medical home interventions that feature shared savings agreements for primary care practices may improve care quality and reduce the utilization of medical services, according to a recent study ...

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