Your providers submit requests to us online for post acute care.
Our automated platform reviews the requests in real time, assessing service management, discharge plans, and health plan case management referral opportunities.
Requests that meet clinical criteria are immediately approved. Our clinical reviewers, including physicians, nurses, social workers, and therapists, consult with your providers about any requests that don’t meet our clinical guidelines.
After approving or optimizing the request, we coordinate your member’s transition to the facility.
Care and monitoring
We stay in communication with your provider as they care for your member and monitor progress and evaluating requests for additional days when needed.
When it’s safe for your member to return home, we manage that transition too. Our home-based care team is available to manage any additional clinical or social needs to ensure optimal care and recovery.
Review request data is shared with your system(s) for claims, care management, and/or reporting purposes.