With the ever-increasing emphasis on reducing costs while improving patient outcomes, utilization management companies are taking on new importance. Using objective and evidence-based criteria they evaluate requested health care services to make fair and timely determinations (on behalf of their clients) about the appropriateness of the services.
The NCQA Utilization Management Accreditation provides a framework for implementing industry best practices to help organizations:
- Conduct fair and timely utilization management decisions using objective, evidence-based criteria.
- Collect and use relevant clinical information.
- Use qualified health professionals to make decisions.
- Align with state requirements.
- Demonstrate the quality of their program to employers, regulatory agencies and health plans.
Learn more today. Fill out the form to the right to receive more information about this program or to speak to an NCQA program expert.