Utilization Review Services

Staff Education

Concerned about staffing shortages?

HIP's Utilization Review and Case Management nurses are available on an "as needed" basis for short term orlong term UR Support assignments:

  • Remote Initial, Concurrent and Retrospective Utilization Review services
  • Remote Emergency Department Review services
  • Pre-Certification Review services
  • Department assessments / Length-of-stay analysis
  • Staff Education (InterQual Criteria / Milliman Care Guidelines)
  • Emergency Department case management
  • Auditing / Denial services

Focused Audits:

  • One Day Stay Medical Necessity Audits
  • Inpatient / Observation Stay Medical Necessity Audits
  • Two Midnight Rule / Denied Claim Audits
  • Inter-Rater Reliability Audits

Our Staff:

  • Registered and Licensed Nurses / CCM Credentialed
  • 5 Years UR/Case Management Experience
  • Epic / Cerner / Meditech / Midas / Endicia Proficient

Clinical Documentation Improvement (CDI) Audits

Credentialed, Experienced staff conduct ongoing concurrent documentation review of Inpatient and Outpatient Accounts.

Interim Leadership

Experienced Leadership staff available for Long or Short term coverage.

Quality Data Abstraction

Credentialed/Experienced staff conduct ongoing case-finding and abstraction of all applicable Cancer / Core Measures Accounts

Contact HIP today. We're waiting to discuss your needs and show you our solutions.