Utilization Review is the process insurance companies use to approve, authorize, or decline services. The purpose of Utilization Review is to screen, and approve the “least-restrictive” clinical services on a peer case basis. The reason insurance carriers use this process is to standardize approval criteria – to only pay for services deemed medically necessary. Our Utilization Review professionals take the paperwork out of our facilities, or providers, hands so they can focus all their attention on delivering the premier quality care for their clients.
This is a very critical step, often overlooked or disregarded, improper and/or poorly managed, which could limit profitability as well as a client’s length of treatment. Inner Circle Billing endeavors to obtain the highest level of care for the longest duration possible for the client to acquire the finest keys to success.