Optimize Members’ Access to Quality Healthcare & Actively Manage Cost Trends

Utilization Management Services

Reduce Costs While Assuring That
Patient Safety Is Never Compromised

One of the biggest challenges facing the healthcare industry today is making sure people are getting the appropriate type of care as soon as possible. Centro Healthcare’s expert clinical staff focuses on just that: the right care at the right time! Utilization Management is a key factor in reducing cost while continuously improving the patient outcome.

Our Utilization Management Services

Centro Healthcare’s Utilization Management Program includes:

Prior authorization

Concurrent review

Retrospective review

Medical necessity reviews

Benefit determinations using medical necessity criteria and transition of care programs

Benefits of Outsourcing Utilization Management Services

Reduce costly clinic and hospital visits

Physicians and organizations can easily monitor the data collected to identify developing or worsening conditions without having to schedule frequent office visits

Keep patients and physicians up-to-date with current patient conditions

Patient’s healthcare status is constantly updated