A very important part of billing in the medical and rehabilitation fields is utilization management. Utilization management is the action of ensuring that health care resources are being properly allocated to a patient. This includes making sure that the treatments and other processes that are being taken in order to care for a certain patient are working effectively and are not being over or under used. Utilization management that is properly implemented can help a patient and their family save money and receive the best treatment as well as save your company or facility resources and make you more money.
Utilization Management Ensures Quality Care
While it is important to manage your facilities resources and money, it is also important to ensure that your patients are receiving the best quality care. That is where utilization management comes into play. Utilization management ensures that medical insurance denials do not happen. If a health provider seems to be asking for too much money from an insurance carrier then a claim may be denied, at the expense of the ill person that the healthcare provider or rehabilitation center is caring for.
So having proper utilization management in place ensures that your company’s services have costs that are correct and that the service you provide to your patient is neither too little nor too much. This also protects your patients because it leaves no room for insurance companies to deny claims and allows patients to be admitted and helped through their illness or addiction as quickly as possible. We at Aspen Ridge Billing offer utilization management options and services in order to give you as the healthcare provider the ability to better care for your patients and focus on what really matters.
Implementing utilization management also makes your company more efficient because you will only be using what resources are required. This will make your company more profitable as well as gain a better reputation as a company that does not back down to insurance claim denials.
How We Can Help You Manage Utilization
Our highly trained and experienced experts here at Aspen Ridge Billing understand how to negotiate with case workers to maximize the number of authorized days at the highest level of care. Not only will we fight for your patients, but we will do all that we can to help them gain access to available and medically necessary treatments. Our most important objective is to help your company, and by helping you with your billing needs, we can achieve your objective of caring for your clients needs.
Through our extensive knowledge of the behavioral health industry, the criteria and guidelines that are required for proper utilization management, and relationships with managed care companies, we provide you with the most current medical criteria needed to ensure better outcomes for authorizations.
As part of our streamlined onboarding process, and continuing through regular updates, our utilization team examines all aspects of your facility, including your mission statement, daily schedules, individual treatment programs and service offerings in order to clearly define what differentiates your programs from those offered at other facilities. We use this information to advocate on behalf of patients and your facility for access to life-changing behavioral health services.
You Make The Call
You are in charge when it comes to utilization management. You could implement your own procedures to help manage your costs and resources, but you may not be aware of the laws and other regulations that govern behavioral health claims. Even if you are aware, sometimes it can be a pain to work around them. That is why you should hire us here at Aspen Ridge Management. We are fully committed to help your company and facility succeed. Contact us today!