Optimize Utilization Review Processes to Improve Quality and Financial Outcomes

Recover Lost Revenue and Decrease Future Denials

To keep up with changes in reimbursement rules and regulations, it’s important to regularly optimize the utilization review program to determine the appropriate level of care for patients to avoid denials. Ultimately, an effective and efficient utilization review program can help hospitals better meet the needs of their patients, reduce claim denials, and maximize reimbursements.  

Press Ganey Clinical Improvement Consulting experts partner with hospitals and health systems across the nation to improve current utilization review processes and recover lost revenue. Our utilization review consulting services include:

  • Development of a Utilization Management program structure to reduce denials and manage front end revenue cycle processes
  • Establishment of systems to perform medical necessity reviews, obtain authorizations for care, and conduct peer to peers for clinical denials
  • Development of a physician advisor program and role development
  • Denials analysis with program adjustment to mitigate
  • Financial analysis of service lines for profitability and return on investment
  • Comprehensive denials management solution for the organization

Using proven Soyring Consulting methods and time-tested tools, our consulting experts deliver measurable results with an average 5:1 return on investment, up to 25% in increased capacity, and a proven ability to help drive organizations to zero hospital acquired conditions. To learn how Press Ganey Clinical Improvement Consulting experts can help your organization improve utilization review processes, complete this brief form and one of our experts will contact you.

Contact us today at 866.345.3887 or complete the form below

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