Utilization Management

Precedence Inc.

A nationally accredited, compassionate, cost effective Utilization Management Program that directs beneficiaries to the most appropriate level of care and monitors the ongoing progress of the patient with clinical criteria and protocols.

Features

 

  • Utilization review by credentialed mental health and substance abuse professionals
  • Concurrent review for intensive outpatient, partial hospitalizations and inpatient care
  • Monitoring of discharges and aftercare
  • Appeals process
  • Out of area and emergency services coverage

Utilization Management Benefits

 

  • Employers benefit through significant reduction in mental health and substance abuse costs by ensuring that only medically-necessary services are being delivered.
  • Employees and families benefit through a process of selectively matching treatment resources with problems.
  • A panel of credentialed providers and facilities.
  • Providing caring, cost effective care.

 

URAC Accreditation

 

Precedence utilization management program is accredited by the URAC. This accreditation provides assurance to patients, providers, purchasers, regulators and employers that the practices of Precedence managed care are performed fairly and reasonably for all parties.                                                                    

Precedence follows standards to ensure our Utilization Management (UM) Review process is clinically sound and we respect patients' and providers' rights while giving payers logical & realistic guidelines to follow.