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What is Utilization Review?
The Importance of Utilization Review
The importance of utilization review cannot be overstated. It is the link between the patient, the provider, and the insurer that enables the patient to receive the proper level of care for the appropriate amount of time.
Unfortunately for the patient, there is often a desire on the insurer’s part to minimize the clinical hours that a client receives. Utilization review functions by advocating for a patient’s specific treatment needs in the face of the insurer’s propensity for money-saving tactics. Here at AHS, we mobilize our compassion for the patient by working to ensure their best chances for recovery are not being curtailed or compromised by an insurer’s aggressive push for cost-effectiveness.
Without this integral part of the process, all decisions regarding the clinical care of the patient would be left vulnerable to cost reduction efforts at the hands of individuals not intimately familiar with the patient’s case.
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