Case Management and Clinical Review Hotline
“Yes, we’re open!”
Our hotline service has been specifically developed to help emergency departments make determinations about inpatient and outpatient status. This will diminish denials by ensuring that the patient status is correct on admission.
- Your facility will be provided with an 800 number where you can call us 24 hours a day, 7 days a week. Your plan will be tailored to meet your facility’s coverage needs.
- Your nurse or physician will provide clinical information to the Utilization Review Specialist. The Utilization Review Specialist will apply the clinical criteria and utilize his or her specialized judgment to render a status recommendation to your facility.
- Your nurse or physician will discuss the case and answer any questions your staff might have. This also provides 1:1 criteria training.
- We will provide a verbal determination, followed by a faxed determination and discussion of the case with referenced criteria.
Help clear up the confusion!
- In the ER, time is critical, and emergency services can’t wait. Our hotline will help you determine the patient disposition quickly and accurately.
- Call us, 24/7, and let us provide you with a recommendation based on your information using up-to-date criteria.
- Getting it right the first time improves patient flow and reduces denials.
Why Use the Hotline?
Our Hotline Service is available 24 hours a day, 365 days per year. Calling one number allows you to speak directly with one of our highly trained utilization management specialists. This proactive approach is critical in helping you to determine medical necessity based on up to date admission criteria. Whether calling from a physician’s office or emergency department, help is only a phone call away.