Your providers assess your member’s whole health needs, develop a care plan, and submit requests to us online for post acute care.
Our automated platform reviews the requests in real time, assessing care plan, and discharge plans.
Requests that meet clinical criteria are immediately approved. Our clinical reviewers, including physicians, nurses, social workers, and therapists, are available to consult with your providers about any requests that don’t meet our clinical guidelines.
Review request data is shared with your system(s) for claims, care management, and/or reporting purposes.