Utilization Review

Our Commitment to You

Our all-RN & CCM staff will work to eliminate unnecessary treatment and the associated costs. We utilize industry-accepted software and criteria to review each case to determine the medical appropriateness of the proposed plan of care, including duration of treatment and care setting.

  • Prospective/Precertification Review – Determine medical appropriateness of planned procedures, diagnostic tests, and hospitalizations. We use InterQual for all precertification evaluations.
  • Concurrent Review – Assess the medical appropriateness of the current treatment plan and continued stay.
  • Retrospective Review – Evaluate the medical appropriateness of past care or treatment.
  • Medical Review – Determine medical appropriateness and future medical needs.
  • Physical Therapy Review – Assess the treatment plan for appropriateness and length.

Do you have a utilization review case for us?

Call 317-573-4519 or

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